Prevalence of eating disorder symptoms in people with insulin-dependent-diabetes : A systematic review and meta-analysis

Abstract

<p><strong>Aims</strong></p><p>To examine the prevalence of eating disorder symptoms (EDS) in 16 years and older individuals with insulin-dependent diabetes including both clinical and subclinical eating disorder symptoms.</p><p><strong>Methods </strong></p><p>We searched PubMed, Embase, Scopus, PsycINFO, and CINAHL databases to discover studies reporting prevalence of eating disorder symptoms in patients with insulin-dependent diabetes (both type 1 and type 2). We performed a meta-analysis to estimate the pooled prevalence of eating disorder symptoms and an independent meta-analysis to estimate the prevalence of insulin omission.</p><p><strong>Results </strong></p><p>A total of 45 studies were included in the meta-analysis of eating disorder symptoms. Diabetes Eating Problem Survey (DEPS-R) was the most frequently used screening tool (in 43 % of studies, <em>n</em> = 20). The pooled prevalence of eating disorder symptoms was 24 % (95 % CI 0.21–0.28), whereas in studies using DEPS-R, it was slightly higher, 27 % (95 % CI 0.24–0.31), with the prevalence ratio (PR) of 1.1. The prevalence differed between screening tools (χ² = 85.83, df = 8, <em>p</em> < .0001). The sex distribution was associated with the observed prevalences; in studies with a higher female prevalence (>58 %), the pooled eating disorder symptom prevalence was higher [30 % (95 % CI 0.26–0.34) vs. 18 % (95 % Cl 0.14–0.22), PR 1.7]. The prevalence of insulin omission was 21 % (95 % CI 0.13–0.33).<br></p><p><strong>Conclusions </strong></p><p>Eating disorder symptoms and insulin omission are common in patients with insulin-dependent diabetes regardless of age. DEPS-R is the most used screening tool. Studies with a higher proportion of female participants report higher prevalence rates.</p>