Poster Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2026

Screening for disordered eating in people with type 2 diabetes during recruitment to a national remote randomised trial (#130)

Evelyn B Parr 1 , Wentao Tang 1 , Zoe Siviour 1 , Katherine Roberts-Thomson 1 , Gennaro D'Elia 1 , Marion MacRae 1 , Bonnie Sanderson 1 , Jessica Stewart 1 , Kristin Maggacis 1 , Stephen A Flint 2 , Ashley H Ng 3 , Monique E Francois 4 , Rich D Johnston 5 6 7 , Tracy A McCaffrey 8 , Elizabeth Holmes-Truscott 9 10 , Linda E Watson 11 , Victoria Silvestro 12 13 , Alice A Gibson 13 , John A Hawley 1 14 , Adrienne Forsyth 15 , Amy T Hutchison 16 17 , Brooke L Devlin 18 , Leah Brennan 19
  1. Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
  2. Diabetes Technology Research Group, Department of Medicine, The University of Melbourne, Melbourne, VIC
  3. Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, VIC, Australia
  4. Faculty of Science, Medicine and Health, School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
  5. School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
  6. SPRINT Research and Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
  7. Carnegie Applied Rugby Research Centre, School of Sport,, Leeds Beckett University, Leeds, United Kingdom
  8. Department of Nutrition, Dietetics and Food, Monash University, Clayton, VIC, Australia
  9. School of Psychology and Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
  10. Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, VIC, Australia
  11. Northern Adelaide Local Health Network (NALHN), South Australia Health, Adelaide, SA, Australia
  12. Western Sydney Diabetes, Integrated and Community Health, Western Sydney Local Health District, Westmead, NSW, Australia
  13. Leeder Centre for Health Policy, Economics and Data, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  14. Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, United Kingdom
  15. School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
  16. School of Medicine, Adelaide University, Adelaide, SA, Australia
  17. Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  18. School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
  19. School of Psychology and Public Health, La Trobe University, Wodonga, VIC, Australia

Background: Eating disorders (ED) and disordered eating (DE) affect up to 34%1 and 50%2 of people with type 2 diabetes (T2D), respectively, globally. Alongside the negative biopsychosocial effects of these mental health conditions, ED/DE effect engagement with, and the appropriateness of, diabetes self-management, including dietary advice. Yet screening is not routinely embedded in diabetes care or research. CARE-T2D is a fully remote randomised controlled trial of continuous glucose monitoring (CGM) and dietetic support. This analysis describes the outcomes of ED/DE screening during recruitment to the CARE-T2D trial. 

Methods: Adults across Australia with non-insulin-managed T2D and HbA1c ³7.0% were recruited online. Eligibility screening included post-consent clinical criteria (HbA1c, no recent CGM use <6 months) and DE risk (EDE-Q) prior to baseline assessments, then randomisation. People identified as being at high risk of ED/DE (EDE-Q global score≥2.8, or psychopathology score≥1.52 plus≥4 on behavioural items (Q14-18)) were excluded and provided with information about support options.

Results: From April 2025 to May 2026, 1,553 expressions of interest were received; n=1124 (72%) were excluded pre-consent and n=248 (16%) post-consent, and n=160 (10%) randomised. Pre-consent exclusions were due to non-response, insulin use, current/recent CGM use, or HbA1c <7.0%; no potential participants self-identified with an ED. Post-consent exclusions included n=97 (7% of exclusions, 23% consented participants) identified as being at high risk of ED/DE: 47% (n=46) met the EDE-Q threshold for probable ED, and 53% (n=51) for DE behaviours.

Conclusion: Screening within a remote T2D trial identified a meaningful proportion of adults who may require further ED/DE assessment and support. The discrepancy between self-identified ED and screening outcomes suggests that undiagnosed ED/DE may be common in adults with T2D. Routine screening protocols and integrated ED/DE care pathways are needed within T2D management. Further research is also needed to better understand the interplay between T2D, diabetes self-management, and ED/DE, as well as referral pathways for appropriate management.

 

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