Subtypes of disordered eating and their diabetes-related and psychosocial concomitants in adults with type 1 diabetes

Abstract

Aims To identify subtypes of disordered eating behaviors (DEB) in type 1 diabetes, describing their behavioral patterns, clinical features, psychosocial well-being, and diabetes-related complications. Methods Baseline data of the Disordered Eating Behaviors and Eating Disorders in Diabetes Type I (DEBBI) study were analyzed (N = 645). Participants completed questionnaires assessing DEB, diabetes-related outcomes, and psychosocial well-being. Latent profile analysis identified subtypes based on DEPS-R indicators, followed by comparisons of demographic, clinical, and psychosocial variables. Results Four distinct DEB subtypes were identified, that differed in intensity and behavioral characteristics: restrained eating (moderate DEB), disinhibited eating (moderate DEB), maintaining high glucose (severe DEB), and dual compensatory behaviors (severe DEB). All DEB subtypes reported significant poorer psychosocial well-being, including elevated diabetes distress, fear of hypoglycemia, depression, and anxiety. The severe DEB subtypes showed poorer diabetes self-management and higher HbA1c levels. Conclusions The diversity of DEB presentations in type 1 diabetes underscores the need to examine specific behavioral patterns. The subtypes revealed distinct clinical features, behavioral patterns, and variations in self-management quality, demonstrating that harmful DEB extends beyond insulin purging alone. Even moderate forms of DEB were linked to significant psychosocial burden, highlighting the importance of early detection and intervention.