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Psychological problems are exacerbated in step with widespread eating disorders among young diabetics

The third of young people with type 1 diabetes who show signs of overeating or binge eating also suffer reduced quality of life, anxiety and depression symptoms.

2021.12.17 | Jakob Binderup Christensen

It is important to identify signs of eating disorders among young diabetics early in order to reduce the risk of worsening the disease and the mental problems that - for many - are associated with them, according to Kevin Patrick Marks, PhD-student, at the Department of Clinical Medicine at Aarhus University. Photo: AU

Eating disorders are a particularly widespread phenomenon among teenagers with type 1 diabetes, and healthcare professionals should do more to identify and treat the problems as early as possible.

This is the conclusion of a new study carried out by researchers from Aarhus University. The study shows that eating disorders among young people with type 1 diabetes are associated with lower quality of life, increased symptoms of depression and anxiety, and impaired physical health.

"Our study confirms that eating disorders – and especially the symptoms of overeating – should be identified early among teenagers with type 1 diabetes. It may well be necessary to intervene even before the young person has been formally diagnosed with an eating disorder," says Kevin Patrick Marks, PhD student at the Department of Clinical Medicine at Aarhus University.

A third has symptoms of overeating

More than 500 young people between the ages of 12 and 17 with type 1 diabetes have participated in the study. All participants have replied to a questionnaire and had a blood sample taken.

The responses were divided into four categories – depending on the symptoms of the eating disorders that the participants exhibited. The categories were "no symptoms of overeating", "overeating", "sub-clinical binge eating" and "clinical binge eating". 

Around a third of the participants in the study (34 per cent) had symptoms of overeating or binge eating, which is more or less in line with previous studies.

Diabetics are particularly vulnerable

It is also well-known that people with type 1 diabetes often gain weight when they begin their insulin treatment. This may have psychological side effects, such as e.g. dissatisfaction with one’s own body.

At the same time, type 1 diabetics are particularly vulnerable because they are forced to constantly consider how food and exercise affects their blood glucose level and must constantly deal with living with a chronic disease.

The new study from Aarhus University reveals that the emotional problems among young type 1 diabetics worsen in step with the eating disorders.

Thus, the participants who are categorized as clinical binge eaters have significantly more symptoms of depression and anxiety than the participants who fall into the other categories.

Risk of complications

Almost eight per cent of the participants in the study reported symptoms of clinical binge eating, which is far above the level of the general population who do not have type 1 diabetes in the age group.

It is not only mental health that is associated with symptoms of these eating disorders.

The study also shows that teenagers who have symptoms of overeating and binge eating have elevated blood glucose levels and a slight tendency to be overweight.

Teenagers with type 1 diabetes who have elevated blood glucose levels due to overeating will also have an increased risk of experiencing complications in connection their diabetes when they grow older.

These complications can damage the eyes, kidneys, nerves, heart, blood vessels, feet and brain function.

"All in all, this means that these young people will have a high risk of developing serious health problems over time. But if the problems are identified early on, it will often be possible to treat both the emotional and physical symptoms before they develop into something serious," says Kevin Patrick Marks.

Awareness of early signs

According to the researcher, the study should be followed up by further research to show how it is possible to identify and treat symptoms of eating disorders in teenagers with type 1 diabetes more quickly and effectively.

Although he also emphasizes that healthcare professionals can already do more to help young people get on the right track, and do so using few means.

"We’ve discovered that the identification of binge eating through the use of a standardized questionnaire may be the warning sign that means that the teenager is referred to a team of professionals who are trained in handling both type 1 diabetes and eating disorders," says Kevin Patrick Marks.



The study in brief

  • The study examines the associations between disordered eating symptoms and other factors like depression, anxiety, quality of life, the level of blood sugar control, and body mass index standard deviation score.
  • The study was conducted researchers and doctors from Aarhus University, Aarhus University Hospital, STENO Diabetes Center and the University of Southern Denmark.
  • The study is financed by research grants from the Danish Diabetes Academy (Novo Nordisk Foundation) and Poul and Erna Sehested Hansens Fond.
  • The study is published in Diabetes Medicine and Clinical Practice




PhD student, Kevin Patrick Marks

Mail: kevmar@clin.au.dk

Phone: +4551804340

Mikael Thastum, professor in clinical children's psychology, Aarhus University. 

Mail: mikael@psyk.au.dk

Phone:  +4587165846

Research, Research, Public/Media, Health, Aarhus University, Health and disease, Academic staff, Department of Clinical Medicine, Health, Exchange students