No association between carbohydrate-counting knowledge and disordered eating behaviors in adults with type 1 diabetes

AIMS: Carbohydrate counting enables flexible prandial insulin dosing in type 1 diabetes but remains cognitively demanding. Concerns persist that such sustained attention to food may contribute to disordered eating behaviors. The primary aim of this study was to examine whether carbohydrate-counting knowledge is associated with disordered eating behaviors. METHODS: This cross-sectional study (NCT07021456) was conducted online. Participants completed questionnaires assessing carbohydrate-counting knowledge (Gluciquizz), disordered eating behaviors (DEPS-R), and likely eating disorders (SCOFF-F). Additional questionnaires evaluated quality of life (ADDQoL), diabetes-related distress (PAID-5), and fear of hypoglycemia (HFS-II short form). Elevated DEPS-R was defined as a score ≥ 20, and likely eating disorders as SCOFF-F ≥ 2. RESULTS: A total of 100 adults with type 1 diabetes were included. No correlation was observed between Gluciquizz and DEPS-R (ρ = -0.03, 95% CI (-0.23 to 0.17), P = 0.73). Similarly, Gluciquizz scores did not differ between participants with SCOFF-F < 2 and ≥ 2 (P = 0.745). Diabetes-related distress was significantly higher among participants with elevated DEPS-R scores (PAID-5 median 15 vs 8; P = 0.006), whereas ADDQoL and HFS-II did not differ significantly. CONCLUSION: In this selected adult population with type 1 diabetes, carbohydrate-counting knowledge was not associated with disordered eating behaviors. However, positive DEB screening was linked with higher diabetes-related distress, supporting the importance of psychosocial assessment.