Mechanisms underlying the development of eating disorders and disordered eating in adolescent females with type 1 diabetes

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-06-30 DOI:10.1111/dme.15397

Caroline Bruun Abild, Esben Thyssen Vestergaard, Jens Meldgaard Bruun, Kurt Kristensen, Rene Klinkby Støving, Loa Clausen

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引用次数: 0

Abstract

Objective

People with Type 1 diabetes (T1D) face an increased risk of eating disorders/disordered eating (ED/DE), with adolescents being particularly vulnerable. Empirical knowledge on the mechanisms underlying development of ED/DE in T1D is crucial for evolving prevention strategies.

Research Design and Methods

Fourteen semi-structured interviews with adolescent females with T1D and ED/DE between 14 and 18 years were conducted and analyzed using reflexive thematic analysis.

Results

Analyses identified four main themes; ‘Interconnected afflictions’, ‘Judgment’, ‘Feeling Different’, and ‘Chaos & Control’, These themes explore the interconnectedness of T1D and ED/DE, with shame and guilt emerging as common underlying mechanism. The development of a biopsychosocial model was based on the integration of these data with existing models.

Conclusions

The study extends previous developmental pathways of ED/DE in adolescents with T1D. We propose a biopsychosocial model that incorporates various factors: predisposing factors such as parental management of T1D and weight gain during adolescence; precipitating factors including comments on weight, frequency of weighing, perceptions of surveillance; the perpetuating bilateral influence of ED/DE and T1D and finally highlighting the protective mechanisms of disease acceptance encompassing parental handling of diagnosis and the contribution of healthcare professionals (HCP's) role in psychoeducation. The present study highlight the vulnerability of adolescence in the presence of T1D, particularly concerning issues related to eating, weight, and body. It offers clinically relevant insights, with the aim to improve communication and management strategies for this very specific group.

Abstract Image

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1 型糖尿病青少年女性患者饮食失调和饮食紊乱的发生机制。

目的：1型糖尿病（T1D）患者罹患进食障碍/进食紊乱（ED/DE）的风险增加，青少年尤其容易受到影响。对 T1D 患者饮食失调/进食障碍发生机制的经验性了解对于制定预防策略至关重要：对 14 至 18 岁患有 T1D 和 ED/DE 的青少年女性进行了 14 次半结构式访谈，并采用反思性主题分析法对访谈结果进行了分析：这些主题探讨了 T1D 和 ED/DE 的相互关联性，其中羞耻感和负罪感是共同的潜在机制。在将这些数据与现有模型进行整合的基础上，建立了一个生物心理社会模型：本研究扩展了以往 T1D 青少年 ED/DE 的发展路径。我们提出了一个包含多种因素的生物心理社会模型：易患因素，如父母对 T1D 的管理和青春期体重增加；诱发因素，包括对体重的评论、称体重的频率、对监控的看法；ED/DE 和 T1D 的持续双边影响，最后强调疾病接受的保护机制，包括父母对诊断的处理和医疗保健专业人员 (HCP) 在心理教育中的作用。本研究强调了青少年在患有 T1D 时的脆弱性，尤其是与饮食、体重和身体相关的问题。它提供了与临床相关的见解，旨在改进针对这一特殊群体的沟通和管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”