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Objective: People with type 1 diabetes (T1D) are at higher risk for disordered eating behaviors (DEB). Emotional dysregulation is a key factor in DEB, presenting a potential focus for new therapeutic approaches. The aim is to explore the relationship between DEB and emotion regulation difficulties, anxiety, depression, and their impact on glycemic control (hemoglobin A1c (HbA1c) in adults with T1D.
Methods: Diabetes Eating Problem Survey‑Revised (DEPS-R), Eating Disorder Examination Questionnaire (EDE-Q), Difficulties in Emotion Regulation Scale (DERS), and Hospital Anxiety and Depression Scale (HADS) were collected from 103 adult participants with T1D. Associations between DEB, difficulties in emotion regulation, anxiety, depression, and HbA1c were investigated using path analysis.
Results: The prevalence of DEB among adults with T1D was 35.9%, according to the DEPS-R. Path analysis revealed that experiencing more difficulty in emotion regulation was associated with higher levels of DEB (β=0.485, P=.001), whereas greater levels of DEB were associated with higher levels of HbA1c (β=0.393, P=.001). Difficulties in emotional regulation, depression, and anxiety (β_indi‑ rect=0.190, P=.001; β_indirect=0.160, P=.001; β_indirect=0.240, P=.001, respectively) indirectly influenced HbA1c.
Conclusion: This study emphasizes the need for screening and addressing DEB in adults with T1D and thoroughly evaluating psychological symptoms when providing diabetes care. Given the association between emotion regulation difficulties and DEB, interventions focusing on enhancing emotional regulation skills might be beneficial when targeting DEB in T1D.
Cite this article as: Usta Sağlam NG, Uysal S, Durcan E, et al. Associations between emotion regulation difficulties, depression, anxiety levels, and disordered eating behavior in adults with type 1 diabetes. Endocrinol Res Pract. Published online May 16, 2025. doi 10.5152/erp.2025.25633.