Identification of Disordered Eating Behaviors in Adolescents with Type 1 Diabetes

Type 1 diabetes is a life-long chronic condition that typically presents in childhood, and approximately 193,000 Americans under age 20 are estimated to have either Type 1 or Type 2 Diabetes. Additionally, approximately 20-30% of adolescents with Type 1 diabetes have disordered eating behaviors or eating disorders. A common way disordered eating manifests in Type 1 diabetes is through manipulation of insulin dosages to promote hyperglycemia and subsequent weight loss. Disordered eating in diabetes can lead to short term complications such as diabetic ketoacidosis, severe hypoglycemia, and chronic long-term health conditions arising from complications of uncontrolled diabetes. Identification and screening for disordered eating in youth can lead to earlier intervention for those at risk and facilitate access to proper treatment. The purpose of this practice improvement project was to educate providers in an urban midwestern pediatric endocrinology clinic on risk factors for disordered eating and implement a process workflow utilizing the Diabetes Eating Problems Survey-Revised (DEPS-R) screening tool. Descriptive statistics were used to determine the effectiveness of the screening tool into practice. Provider input was also evaluated regarding the implemented workflow and screening tool. Following an education session with the clinic?s providers, two out of three providers had perceived improvement in their knowledge about disordered eating behaviors in T1DM and felt the DEPS-R would be beneficial for practice. During the 6-week implementation process, 10.6% (n=5) of screened adolescents were detected as needing further evaluation for disordered eating behaviors. The post-project evaluation input from the providers indicated they felt the implemented workflow and DEPS-R process was helpful in detecting adolescents at risk for disordered eating behaviors