Diabetes distress may adversely affect the eating styles of women with type 1 diabetes

The aim of this study was to determine the relationships among diabetes distress, fear of hypoglycemia, and eating styles in women with type 1 diabetes (T1DM). Fifteen women (mean age 37 ± 13.5 years) with T1DM completed surveys measuring diabetes distress, fear of hypoglycemia (FOH), and eating style. Height, weight, and A1C were obtained, and open-ended comments regarding hypoglycemic concerns and experiences were recorded. Diabetes distress was positively associated with A1C (r = .655, p = .008). High levels of external (73 %), emotional (47 %), and restrained (53 %) eating styles were reported. Emotional and external eating styles were positively associated with diabetes distress (r = .575 and r = .622; p < .05). Those with poorer glycemic control (A1C > 7 %; 53 mmol/mol) had higher levels of restrained eating behavior (F = 10.69, p = .006) and greater interpersonal distress (F = 5.916, p = .03) than those with better glycemic control (A1C < 7 %; 53 mmol/mol). A nonlinear relationship was identified between interpersonal distress and FOH (behavior subscale, p = .0383) indicating that fewer behavioral approaches were employed to avoid hypoglycemia at higher distress levels. The women in this sample were emotionally burdened by their disease. Distress was associated with eating styles linked with overeating and poor glycemic control. High levels of emotional and external eating styles may have important clinical implications for those with T1DM.