A narrative systematic review of definitions and diagnostic criteria for disordered eating and eating disorders in type 1 diabetes.

The absence of a standardised case definition of T1DE and its severity hinders effective screening, diagnosis and treatment.

缺乏标准化的T1DE病例定义及其严重程度阻碍了有效的筛查、诊断和治疗。

This systematic reviewaimed to (1) synthesise existing case definitions and diagnostic criteria for T1DE in adults and (2) identify key characteristics to inform consensus for future diagnostic criteria.

这项系统评价旨在（1）综合现有的T1DE成人病例定义和诊断标准，以及（2）确定关键特征以通知未来诊断标准的共识。

Methods

A systematic reviewwas conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) guidelines.

系统评价是按照系统评价和荟萃分析首选报告项目（PRISMA）指南进行的。

Eligible studies involved adults (≥18 years) with type 1 diabetes assessing disordered eating; paediatric studies, mixed samples without disaggregated data, non-empirical designs and non-English publications were excluded.

符合条件的研究涉及评估1型糖尿病成人患者的饮食失调；排除了儿科研究、未分层的混合样本、非实证设计和非英语出版物。

PubMed, MEDLINE, EMBASE, CINAHL and PsycINFO were searched up to November 2025 for peer-reviewed studies involving adults with T1DE.

在PubMed、MEDLINE、EMBASE、CINAHL和PsycINFO上搜索了截至2025年11月的同行评审研究，涉及T1DE成人。

Qualitative and quantitative data on definitions, diagnostic criteria and assessment tools were extracted.

提取了关于定义、诊断标准和评估工具的定性和定量数据。

Study quality was appraised using a modified Graphical Appraisal Tool for Epidemiological studies (GATE) checklist.

使用修改后的流行病学研究图形评估工具（GATE）清单对研究质量进行了评估。

Due to heterogeneity of data, a narrative synthesis of findings was performed to describe current definitions of T1DE.

由于数据的异质性，进行了叙述性综合以描述当前T1DE的定义。

Results

Sixty-one studies met the inclusion criteria, with a pooled sample of 111,208 participants (76% women) from over 22 countries.

六十一项研究符合纳入标准，共有111,208名参与者（76%为女性），来自22多个国家。

T1DE was defined using a heterogeneous array of terms, diagnostic frameworks and assessment tools (29 distinct methods).

T1DE的定义使用了各种术语、诊断框架和评估工具（29种不同的方法）。

The Diabetes Eating Problem Survey-Revised (DEPS-R) was the most used questionnaire, but many studies relied on criteria adapted from general eating disorder classifications or generic questionnaires.

《糖尿病饮食问题调查问卷-修订版》(DEPS-R)是最常用的问卷，但许多研究依赖于从一般饮食障碍分类或通用问卷中改编的标准。

Approximately three-quarters of the studies assessed insulin omission behaviours, but the operationalisation of the cognitions for insulin omission varied widely.

大约四分之三的研究评估了胰岛素遗漏行为，但对胰岛素遗漏的认知操作化差异很大。

Beyond physiological markers such as HbA1c and BMI, studies explored various diabetes-related and psychological constructs, although often considering diabetes and disordered eating separately rather than as an integrated condition.

除了HbA1c和BMI等生理标志物外，研究还探讨了各种与糖尿病相关的和心理构建，尽管通常将糖尿病和饮食失调分开考虑，而不是作为一个综合条件。

conclusions/interpretation

This systematic reviewhighlights the lack of a unified, evidence-based definition of T1DE, resulting in inconsistent screening, diagnostic and reporting practices.

这项系统评价突显了缺乏一个统一的、基于证据的T1DE定义，导致筛查、诊断和报告实践不一致。

Establishing clear, consistent, evidence-based diagnostic criteria and screening questionnaires for T1DE is critical to improving early detection and developing targeted interventions.

为T1DE建立明确、一致、基于证据的诊断标准和筛查问卷对于提高早期发现和开发针对性干预措施至关重要。

These findings provide a foundation for refining T1DE definitions as a stepping stone to an international consensus definition.

这些发现为改进T1DE定义提供了基础，作为通往国际共识定义的垫脚石。

study_registration

PROSPERO registration no.

PROSPERO注册号。

CRD420250223622 FUNDING: King's College London and King's College Hospital through the KMRT KCH Joint Research Committee studentship.

CRD420250223622 资金来源：伦敦国王学院和国王学院医院通过KMRT KCH联合研究委员会学生奖学金。

This work was also conducted as part of the National Institute for Health Research (NIHR; CS-2017-17-023)-funded STEADY project (Safe management of people with Type 1 diabetes and EAting Disorders studY).

这项工作也是作为国家卫生研究院（NIHR; CS-2017-17-023）资助的STEADY项目的一部分进行的（1型糖尿病和饮食障碍患者的安全管理研究）。

NZ's salary was part-funded by the NIHR via the NIHR Clinician Scientist award to MS; JT and KI are part-funded by the NIHR Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.

NZ的薪水部分由NIHR通过MS的NIHR临床科学家奖项资助；JT和KI部分由南伦敦和莫兹利NHS基金会信托和伦敦国王学院的NIHR心理健康生物医学研究中心资助。

MS was funded through her NIHR Clinician Scientist Fellowship (CS-2017-17-023).

MS是通过她的NIHR临床科学家奖学金（CS-2017-17-023）获得资助的。