Research Information System
Endocrinologia, Diabetes y Nutricion, vol.73, no.4, 2026 (Scopus)
Objective: Adolescence is marked by significant physiological and psychological changes that can lead to body image dissatisfaction and eating disorders (ED). Adolescents with type 1 diabetes mellitus (T1DM) may engage in restrictive dieting or insulin manipulation to control weight, risking severe complications. This study aims to identify adolescents with T1DM at risk for diabetes-specific eating behaviors using the Diabetes-Specific Eating Problems Scale-Revised (DEPS-R) and assess associated psychopathological factors, including diabulimia. Methods: Adolescents (10–18 years) with T1DM who were under follow-up in our clinic within the past year were included. Patients were categorized into 3 metabolic control groups according to HbA1c levels: good (<7%), moderate (7–9%), and poor (>9%) based on the cumulative glycemic index that was calculated from the average HbA1c values over the past year. Eating behaviors were assessed using the DEPS-R scale, with scores≥20 indicating risk for ED. Individuals with high DEPS-R scores (at-risk group) were referred for psychiatric evaluation. Results: A total of 11.2% our of 80 adolescents, were identified as at risk for EDs. The mean DEPS-R score of the at-risk group was significantly higher vs the other group (25.8±3.5 vs 10.0±4.6, p<0.001). No significant differences were observed for age, gender, height SDS, and relative BMI. Although the at-risk group had a higher cumulative glycemic index and longer diabetes duration, there was no statistical significance (p=0.29, 0.28, respectively). Logistic regression analysis, adjusted for age, sex, diabetes duration, and comorbidities, did not identify statistically significant predictors of high DEPS-R scores. A weak positive correlation was found between high DEPS-R scores and basal-bolus insulin therapy (r=0.09, p=0.03). Psychopathology was observed in 55% of high-risk adolescents, with a higher prevalence in the poor metabolic control subgroup. Conclusion: Although the DEPS-R scale is a valuable tool for identifying not only EDs but also early changes in eating behaviors in adolescents with T1DM, psychiatric evaluation is essential for confirming underlying psychopathology. Psychological factors play a key role in shaping eating behaviors, highlighting the need for integrated care combining diabetes management with psychological support.