640-P: Disordered Eating Screening within a Pediatric Diabetes Clinic

Adolescents with type 1 (T1D) and type 2 diabetes (T2D) are at elevated risk for mood and eating disorders, which are associated with numerous negative outcomes. Depression screening is now standard within pediatric diabetes clinics, yet formal screening for disordered eating is rare. Due to the comorbidity between these presentations, depression screening may effectively identify youth with disordered eating concerns. Goals were to describe the frequency of depressive and disordered eating symptoms for adolescents with T1D and T2D and examine associations between these symptoms. In a retrospective analysis of clinical data from outpatient medical visits in patients with T1D and T2D aged 13.0 to 18.9 years, body image and extreme weight control behaviors were assessed from a self-reported adolescent health questionnaire (AHQ; DiFiore et al., 2023) and depressive symptoms via the Patient Health Questionnaire-9 Adolescent Version (PHQ-9; Johnson et al., 2002). On average, patients with T1D (n = 216) were 15.9[1.25] years old, had diabetes for 7.7 [4.08] years, and an average BMI%ile of 75.95 [22.03]; while those with T2D (n = 85) were 16.1 [1.16] years old with diabetes for 2.7 [1.29] years, and an average BMI%ile of 98.05 [3.26]. Regarding depressive symptoms, 6.0% (T1D) and 11.8% (T2D) scored at or above threshold (≥ 11) on the PHQ-9. Concerns of body image were reported in 13.0% (T1D) and 42.4% (T2D) and of extreme weight control behaviors in 6.0% (T1D) and 27.1% (T2D). Linear regressions adjusted for relevant background variables including BMI indicated higher PHQ-9 scores were associated with both increased body image concerns (T1D: B = 4.14, p < .001; T2D: B = 3.41, p = .004) and extreme weight control behaviors (T1D: B = 3.49, p = .002; T2D: B = 4.30, p < .001). These findings highlight concern for disordered eating, especially within T2D, and routine screening is indicated. If clinic constraints limit multiple screenings, follow up disordered eating screening for those with concerning depressive symptoms may be appropriate.