Document Type

Thesis

Date of Degree Completion

Spring 2025

Degree Name

Master of Science (MS)

Department

Nutrition

Committee Chair

Nicole Stendell-Hollis

Second Committee Member

Tafere Belay

Third Committee Member

Kelly Pritchett

Abstract

The purpose of this study was to determine the prevalence and factors that contribute to the risk of diabulimia by using the validated Diabetes Eating Problem Survey-Revised (DEPS-R) (Markowitz et al., 2009) screening tool in adults living in the U.S., as well as to examine differences in individuals at-risk and not-at-risk for diabulimia. This observational study involved a 30-question Qualtrics survey containing the DEPS-R distributed via various social media outlets and flyers on the CWU Ellensburg campus. Participants were required to be 18 years or older, diagnosed with T1DM for more than one year, and live in the U.S to participate. A total of 112 participants, 42 (37.2%) males and 68 (60.7%) females; age: 28.89 ± 10.48 years, were included in analysis. Of the sample, 43.8% were at risk for diabulimia based on the DEPS-R score cutoff. Gender (X2 = 0.013, p = 0.532), age (X2 = 1.563, p = 0.458), BMI (X2 = 6.004, p = 0.111), diabetes education (X2 = 0.717, p = 0.869), and HbA1C (X2 = 0.221, p = 0.400) were not significantly associated with risk. However, a previous eating disorder diagnosis (X2 = 16.117, p < 0.001), insulin restriction (X2 = 31.638, p < 0.001), and race (X2 = 13.655, p < 0.001) were associated with risk. In conclusion, it is essential to screen all patients with T1DM for diabulimia throughout their lifetime, which may necessitate revisions to current protocols regarding the frequency and content of diabetes education. The current study found contradicting literature on the factors contributing to an increased risk of diabulimia, including a higher prevalence in males than expected. Therefore, this indicates the need for future research and revisions to diagnostic criteria.

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