The diabEAT Study: Insulin dElivery Technologies And eaTing Behaviours in People With Type 1 Diabetes

NCT07348432 | Recruiting

• 1 other identifier: 23-07-045
• Study Type: observational
• Target: 106
• Locations: 1 country
• Sites: 1

Brief Summary

Type 1 diabetes is an autoimmune health condition that requires daily injections of insulin. Insulin allows the body to use energy from carbohydrates in food. Disordered eating behaviours, like restricting food intake to lose body weight, are more common in women and people with type 1 diabetes, compared to those without because they must practice carbohydrate counting. Carbohydrate counting means identifying, measuring, and planning carbohydrate intake to match insulin dosage. New technologies, such as automated insulin delivery (AID) systems adjust insulin delivery in a blood sugar responsive manner. AID is rapidly replacing conventional insulin delivery like injections or non-automated insulin pumps since it reduces management burden and improves blood sugar levels. It is not known if AID reduces food management and disordered eating behaviours. This study aims to: 1. investigate the relationship between AID and eating behaviours according to gender for youth (12 to 17 years), and adults (18 years and older). 2. Determine the limit of carbohydrate counting inaccuracy to maintain stable blood sugar levels according to insulin delivery method (AID, injections, or pumps). It is hypothesized that those who use AID will have lower disordered eating behaviours and will maintain stable blood sugar levels while allowing for higher carbohydrate counting inaccuracy. This will be a cross-sectional cohort study of people with type 1 diabetes who are 12 years of age or over. Participants will be recruited through the BETTER registry and social medias across Canada. This research is needed to improve nutrition guidelines for type 1 diabetes in the context of new technologies like AID. Evidence from this study may reduce food management burden, lower the risk of disordered eating behaviours, and prevent eating disorders and medical complications.

Conditions

Feeding and Eating Disorders; Eating Behavior; Type 1 Diabetes; Autoimmune Diseases; Endocrine System Diseases; Insulin Dependent Diabetes Mellitus

Keywords

Automated Insulin Delivery; Disordered Eating Behaviours; Nutrition; Type 1 Diabetes

Outcome Measures

Primary Outcomes (3)

• Disordered Eating Behaviours

  The primary outcome variable disordered eating behaviours will be measured through the Three Factor Eating Questionnaire-Revised 21 (TFEQ) in adults. The primary outcome for youth (12 to 17y) is the Child Three Factor Eating Questionnaire 17, which is an adapted questionnaire from the TFEQ. TFEQ refers to current dietary practice and measures 3 different aspects of eating behaviour: cognitive dietary restraint (conscious restriction of food intake) score ranges from 6 to 24, uncontrolled eating (tendency to eat more than usual due to loss of control over intake accompanied by subjective feelings of hunger) score ranges from 9 to 36, and emotional eating (inability to resist emotional cues) score ranges from 6 to 24. Higher scores in the respective scales indicate greater level of restrained, uncontrolled, or emotional eating.

  Collected at one time point per participant at the time of survey completion. The study has an observational, cross-sectional design from April 2024 to estimated May 2026.

• Diabetes Disordered Eating Behaviours

  The Diabetes Eating Problem Survey (DEPS-R) is a 16-item questionnaire for youth and adults over the age of 12 years. It refers to disordered eating behaviours specific to people with type 1 diabetes. The score ranges from 0 to 80, with a higher score indicating higher risk of disordered eating.

  Collected at one time point per participant at the time of survey completion. The study has an observational, cross-sectional design from April 2024 to estimated May 2026

• Orthorexia Eating Behaviours

  The Teruel Orthorexia Scale is a 17-item questionnaire, that is validated in both English and French. It measures 'healthy orthorexia' behaviours as well as behaviours related to 'orthorexia nervosa'. Healthy orthorexia describes individuals who have a high interest in healthy eating, but in a non-pathological dimension of orthorexia. This sub scales score ranges from 0 to 27. Orthorexia nervosa includes behaviours that are related to healthy eating that may cause malnutrition, emotional distress, and social impairment. This subscale ranges from 0 to 24. A higher score represents more orthorexia symptoms.

  Collected at one time point per participant at the time of survey completion. The study has an observational, cross-sectional design from April 2024 to estimated May 2026

Secondary Outcomes (2)

• Glucose Time In Range (TIR)

  Collected at one time point per participant at the time of survey completion. The study has an observational, cross-sectional design from April 2024 to estimated May 2026.

• Coefficient of Variation (CV)

  Collected at one time point per participant at the time of survey completion. The study has an observational, cross-sectional design from April 2024 to estimated May 2026.

Interventions

Automated Insulin Delivery (AID) Systems DEVICE

AID automatically adjusts insulin delivery by using continuously measured blood glucose levels. AID use will be determined through the initial questionnaire through the following questions: Do you currently use the pump as an automated insulin delivery system (connected to a CGM with automated insulin adjustments)? Yes, a commercial AID with control IQ (Tandem) or SmartGuard (Medtronic) Yes, a non-commercial open-source do-it yourself AID (e.g., Loop) No, they use it as a manual (non-automated) pump or with a suspend on low functionality (e.g., Basal IQ) I prefer not to answer I don't know The type of AID system (hybrid, advanced hybrid, etc.) will also be confirmed. The exposure variable will be coded as a binary-categorical variable of AID use (yes or no) with no representing all other non-AID insulin pumps or injections.

Carbohydrate Counting Inaccuracy Percentage BEHAVIORAL

Carbohydrate counting inaccuracy: will be determined by subtracting the estimated carbohydrates (by participant) by the actual amount of carbohydrate (through diet analysis) divided by the actual amount of carbohydrate, multiplied by 100, to determined the percentage. Estimated carbohydrate counts will be entered at each meal and snack by the participant in a daily log provided to the participant. Carbohydrate amounts will be collected through a 4-day food diary through the phone application Keenoa (carb count from the app will be blinded to the participant), and reviewed by a research assistant with education in dietetics.

Eligibility Criteria

• Age: 12 Years+
• Gender Eligibility Details: self-identified gender: boy/man, girl/woman, non-binary, other
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

People living with type 1 diabetes

You may qualify if:

• years of age or older
• Living in Canada
• Living with type 1 diabetes for more than 1 year
• Using at least 2 insulin injections per day or using an insulin pump
• Using current insulin delivery system for 3 months or more

You may not qualify if:

• Are pregnant or currently are breastfeeding
• Don't speak French or English
• Does not have a smart phone (to download applications)

Sponsors & Collaborators

• McGill University: lead
• Laval University: collaborator
• Université de Montréal: collaborator
• University of Windsor: collaborator

Study Sites (1)

McGill University

Montreal, Quebec, H9X 3V9, Canada

RECRUITING

Related Publications (28)

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• Gagnon C, Aimé A, Bélanger C. French Validation of the Diabetes Eating Problem Survey-Revised (DEPS-R). Can J Diabetes. 2013;37(1):60. doi:10.1016/j.jcjd.2013.03.009

  BACKGROUND

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MeSH Terms

Conditions

Diabetes Mellitus, Type 1; Feeding and Eating Disorders; Feeding Behavior; Autoimmune Diseases; Endocrine System Diseases

Interventions

Insemination, Artificial, Heterologous; Drug Delivery Systems

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Immune System Diseases; Signs and Symptoms, Digestive; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders; Behavior, Animal; Behavior

Intervention Hierarchy (Ancestors)

Insemination, Artificial; Reproductive Techniques, Assisted; Reproductive Techniques; Therapeutics; Investigative Techniques; Insemination; Reproduction; Reproductive Physiological Phenomena; Reproductive and Urinary Physiological Phenomena; Drug Therapy

Study Officials

• Anne-Sophie Brazeau, PhD

  McGill University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Courtney South, MSc

CONTACT

705-527-4843; courtney.south@mail.mcgill.ca

Anne-Sophie Brazeau, PhD

CONTACT

514-398-7848; anne-sophie.brazeau@mcgill.ca

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: September 22, 2025
• First Posted: January 16, 2026
• Study Start: July 29, 2024
• Primary Completion: January 31, 2026
• Study Completion: May 1, 2026
• Last Updated: January 16, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)