Type 1 diabetes feasibility study exploring the relationship between carbohydrate counting and disordered eating

Aims: A feasibility study to investigate the relationship
between carbohydrate counting and disordered eating in
patients with type 1 diabetes. Data previously presented
(Diabetes UK Conference 2023) found no relationship between years spent carbohydrate counting and disordered
eating. Discussions with young people with type 1 diabetes
suggested the age patients take responsibility for carbohydrate counting might be an additional factor to consider.
Methods: Forty-two participants with type 1 diabetes from
the UK, aged 16 to 55 (mean age 37 years, mean diagnosis age 21 years) completed an online questionnaire using
validated screening measures, Diabetes Eating Problem
Survey (DEPS-R), and Eating Disorder Examination
Questionnaire (EDEQ), and bespoke questions about carbohydrate counting to measure the relationship between
counting carbohydrate intake and disordered eating.
Results: Analysis identified a weak negative correlation
between the age at which participants took responsibility
for carbohydrate counting and self-reported disordered
eating (EDEQ r=−0.382 p=0.034), but a moderate negative correlation with diabetes-specific eating problems
(DEPS-R r=−0.518 p<0.001).
Conclusion: Our preliminary data suggest a possible association between the age of initiating self-management of carbohydrate to insulin dosing and adverse eating behaviours. This might suggest that the younger a person living
with type 1 diabetes takes responsibility for carbohydrate
counting, the higher their potential risk of disordered eating. Future work will develop novel measures of counting carbohydrates in practice, directed by lived experience
and healthcare practitioners' testimonials to ascertain potential interventions and fully powered studies in order to explore potential confounders such as age of diagnosis.