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Purpose It was aimed to investigate the frequency of the risk of diabetes-specific eating disorder (DSED) in adolescents with type 1 diabetes mellitus (T1DM) and to reveal the accompanying psychopathologies. Methods Adolescents with T1DM aged 12–18 who applied to the pediatric diabetes outpatient clinic between July 2021 and March 2022 were included. Diabetes Eating Problem Survey-Revised (DEPS-R) was applied to all patients to determine the risk of DSED. In order to detect accompanying psychopathologies, Eating Disorder Examination Questionnaire (EDE-Q), Child Anxiety and Depression Scale-Child version (RCADS) and Parenting Style Scale were applied. After completing the scales, semi-structured interviews were conducted with all patients by a child and adolescent psychiatrist. Results Ninety-two adolescents (45 boys, 47 girls) were included. DSED risk was found in 23.9% of the cases. A positive correlation was found between DEPS-R and EDE-Q scores (p = 0.001, rho = 0.370). RCADS mean scores were significantly higher in the group with DSED risk (p Conclusion Almost one-fourth of adolescents with T1DM were found to be at risk of DSED. Routine screening of adolescents with T1DM with the DEPS-R scale may provide early detection of DSED, and referral of those at risk to child psychiatry enables early diagnosis and intervention for both eating disorders and accompanying psychopathologies. Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.

Introduction Metabolic control in type 1 diabetes (T1D) depends on many factors such as eating habits, exercise and lifestyle. The objective of this study was to investigate how these factors were affected during the coronavirus disease 2019 (COVID-19) lockdown and impacted metabolic control in children with T1D. Materials and method One hundred children with T1D were enrolled in the study. Anthropometric measurements, snack and meal frequency, carbohydrate consumption, HbA1c levels, and exercise patterns were recorded and compared before and after the lockdown. Subjects were divided into two subgroups—patients with decreased and patients with increased HbA1c levels after the lockdown—and comparisons of the same parameters were also made between these two subgroups. Results In the overall group, the mean HbA1c level was significantly higher after the lockdown compared to before (p = 0.035). Meal schedules changed due to delayed sleep and waking times, and total daily carbohydrate consumption increased in the subgroup with increased HbA1c while it decreased in the subgroup with decreased HbA1c (p Conclusion Our study supports the notion that blood sugar management in children with T1D worsened during the COVID-19 pandemic. Although it is not possible to explain this with any one factor, some behavioral changes observed in our study, such as inactivity, irregular meal frequency and timing, and irregular sleep and waking patterns appeared to be associated with blood sugar management.

Amaç: Tip 1 diabetes mellitus, insülin eksikliği ve hiperglisemi ile karakterize kronik bir hastalıktır. İyi bir glisemik kontrolün için yaşam boyunca günde ortalama en az sekiz defa kan şekeri ölçümü, sağlıklı besinlerin seçimi, porsiyon kontrolü ve düzenli egzersiz gerekmektedir ve tüm bunlar diyabetli bireylerin birçoğunda kaygıya neden olmakta ve yeme bozuklukları riskini arttırmaktadır. Diabulimia, diyabetli bireylerde, vücut ağırlığında kayıp sağlama amacıyla, kasıtlı olarak insülin dozunu azaltmak ve/veya atlamayı ifade eder. Bu çalışmanın amacı diyabete özgü yeme bozukluğu olan diabulimia açısından riskli adölesanların sıklığını araştırmak, yeme bozukluğu gelişmesi riski ile metabolik kontrol ve vücut kitle indeksi arasındaki ilişkisini değerlendirmektir.Gereç ve Yöntem: Çalışmaya Tip 1 diabetes mellitus tanısıyla izlenen 10-18 yaş arası 129 olgu dahil edildi. Katılımcılara DEPS-R (Diabetes Eating Problem Survey, Diyabette Yeme Sorunları Anketi) yüz yüze uygulandı. Demografik, antropometrik parametrelere ilişkin veriler ve HbA1c değerleri hastaların tıbbi dosyalarından elde edildi.Bulgular: Katılımcıların DEPS-R puanları incelendiğinde riskli olguların %53,2‟si (n=25) kız, %46,8‟i (n=22) erkek, toplamda 47 olguda (%36,4) bozulmuş yeme davranışı riski saptandı. Olgular DEPS-R puanına göre yeme davranışı bozukluğu açısından risksiz ve riskli iki gruba ayrılarak incelendiğinde HbA1c ve vücut kitle indeksi riskli grupta anlamlı olarak yüksek saptandı. DEPS-R skoru ile diyabet yaşı, vücut kitle indeksi ve HbA1c değeri arasında zayıf korelasyon saptandı.Sonuç: Riskli diyabetli bireylerde diabulimia gelişmesini önlemek ve hali hazırda yeme bozukluğu geliştirmiş çocukların saptanmasında rutin tarama önem kazanmaktadır. Bu konu ile ilgili daha fazla çalışmaya ihtiyaç olmakla beraber özellikle açıklanamayan kilo kaybı ve kötü metabolik kontrolde diabulimia olasılığı akılda tutulmalıdır ve etkili tedavi için klinisyenlerin farkındalığı arttırmalıdır., Aim: Type 1 diabetes mellitus is a chronic disease characterized by insulin deficiency and hyperglycemia. A good glycemic control requires blood glucose measurement at least eight times a day throughout life, selection of healthy foods, portion control and regular exercise, all of which cause anxiety and increase the risk of eating disorders in many individuals with diabetes. Diabulimia refers to the deliberate reduction and / or skipping of insulin dose in individuals with diabetes, with the aim of achieving weight loss. The aim of this study is to investigate the prevalence of adolescents at risk of diabulimia, and to evaluate the association of developing eating disorders with metabolic control and body mass index.Materials and Methods: 129 patients between the ages of 10-18 who were followed up with the diagnosis of Type 1 diabetes mellitus were included in the study. The Eating Problems in Diabetes Questionnaire (DEPS-R) was applied face-to-face. Data on demographic and anthropometric parameters and HbA1c values were obtained from the patients’ medical files.Results: When the DEPS-R scores of the participants were examined, 53.2% (n = 25) of cases at risk were female, 46.8% (n = 22) were male, and a total of 47 cases (36.4%) had a risk of impaired eating behavior. HbA1c and body mass index were found to be significantly higher in the group at risk when the cases were divided into two groups that were at risk or not in terms of eating behavior disorder according to the DEPS-R score. A weak correlation was obtained between DEPS-R score and diabetes age, body mass index and HbA1c value.Conclusion: Routine screening gains importance to prevent the development of diabulimia in individuals with diabetes and to detect the ones who have already developed eating disorders. Although more studies are needed on this subject, diabulimia, especially in cases of unexplained weight loss and poor metabolic control, should be kept in mind, and clinicians should increase awareness for effective treatment.