Abstract
Background: Type 1 diabetes mellitus is a chronic autoimmune condition, resulting in the destruction of pancreatic beta cells and insufficient insulin to maintain glycaemic control. Feeding and eating disorders are psychological disorders resulting in disturbed or abnormal eating behaviours and distress about body weight or shape. It is known that people with type 1 diabetes have increased incidence of disordered eating behaviour compared to healthy controls, although little is known about the predictors of this disordered eating behaviour in people with type 1 diabetes.
Objectives: The aim of this integrative review was to identify the predictors of disordered eating behaviour in people with type 1 diabetes.
Methods: A systematic approach was used to conduct an integrative review of peer reviewed primary research, published from 2010-2020. Databases searched were, CINAHL, Ovid (Medline), PsychINFO, Embase and Google Scholar. The studies had to include participants of any gender and age with a diagnosis of type 1 diabetes and eating disorder aetiology. Studies were excluded if they were referring to night eating, pica or rumination disorder. Articles were assessed for methodological quality using the Joanna Briggs Institute critical appraisal tools. Narrative analysis was used to analyse and categorise findings into the type of predictors of disordered eating behaviour in people with type 1 diabetes under static and dynamic risk factors.
Findings: Static risk factors were found to be associated with future risk of disordered eating behaviour in people with type 1 diabetes and include, gender, age, diabetes duration and age of diabetes onset. Dynamic risk factors identified concurrent disordered eating behaviour in people with type 1 diabetes and include BMI, negative affect, dieting and eating attitudes, HbA1c, diabetes management methods and diabetes stress/diabetes conflict.
Conclusions: Knowledge about both static and dynamic risk factors may inform the detection, prevention and treatment of disordered eating behaviours in people with type 1 diabetes and hence help to improve patient outcomes.