Relationship between health responsibility and disease acceptance, and its impact on dietary adherence in type 1 diabetic adolescents: the mediating role of eating disorders

Abstract

Introduction and objective: In type 1 diabetes, responsibility for health and disease acceptance can influence dietary adherence. This study examined how responsibility for health and disease acceptance affect dietary adherence in young patients with type 1 diabetes, considering the role of symptoms of eating disorders. Materials and methods: The observational cross-sectional online questionnaire study was conducted in 190 patients aged 12–18 years with type 1 diabetes, or in their parents, between May 2021 and May 2023. The study employed various scales including the Diabetes Dietary Guidelines Adherence Index, Acceptance of Illness Scale, Diabetes Eating Problem Survey-Revised Scale, and Sense of Responsibility for Health Scale. A model was developed from the literature data, showing the influence of responsibility for health and disease acceptance on dietary adherence, considering the mediating role of eating disorders. Results: The degree of dietary adherence by adolescents with type 1 diabetes depended on the level of their acceptance of the disease, sense of responsibility for their own health, and severity of symptoms of eating disorders. The level of acceptance of the disease had a negative impact on adherence to the diet, while the effect of the study participants’ sense of responsibility for health on their dietary adherence was positive. The occurrence of symptoms of eating disorders had a negative impact on adherence to dietary recommendations. Conclusions: When designing and implementing educational interventions for patients with type 1 diabetes, actions aimed at strengthening the sense of responsibility for their own health and identifying the risk of eating disorders should be taken into account.