630-P: Objective Self-Management Behaviors in Adolescents with Disordered Eating

Introduction: The positive association between disordered eating and A1C in individuals with type 1 diabetes is well-established, but little is known about the association between disordered eating and objectively measured self-management behaviors, which are essential behavioral precursors to A1C. The goal of this study was to describe these associations in adolescents with type 1 diabetes.

Methods: Participants included N=142 adolescent pump users (M age=13.8±2.1 years; M A1C=8.0±1.5%; 82.5% White, Non-Hispanic; 50.0% female) who completed the 16-item Diabetes Eating Problems Survey-Revised (DEPS-R), a type 1 diabetes-specific self-report questionnaire. A cut point of ≥20 was used to identify those with clinically elevated symptoms of disordered eating warranting further attention. Self-management behaviors were calculated using data exclusively obtained from devices (i.e., no self-reported data).

Results: Adolescents (n=26; 19%) who reported elevations on the DEPS-R engaged in significantly fewer self-management behaviors, including blood glucose readings per day [t(151)=3.0, p<0.01], carbohydrate entries per day [t(150)=3.3, p<0.001], and boluses administered per day [t(151)=2.3, p<0.05]. Adolescents with clinically elevated disordered eating scores also entered fewer carbohydrates per day into their insulin pump (137.6 vs. 90.8 grams of carbohydrates) [t(150)=3.3, p<0.001].

Conclusions: This is the first study to examine the association between disordered eating behaviors and objectively measured self-management behaviors in youth with T1D that use an insulin pump. Differences in self-management behaviors between those who reported elevations on the DEPS-R vs. those that did not were particularly pronounced for behaviors related to food. Objective data from device downloads may be a useful tool to cue providers to inquire about eating patterns during routine visits.