iACT for Type 1 Diabetes with Eating Disorders
Recruiting in Palo Alto (17 mi)
+1 other location
Overseen ByRhonda Merwin, PhD
Age: < 65
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Duke University
Disqualifiers: Suicidal ideation, Anorexia, Substance abuse, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial tests a new mobile app called iACT to help people aged 16-45 who have type 1 diabetes and binge-purge eating disorders. The app aims to improve blood sugar control and reduce eating disorder symptoms by offering support and management tools. The iACT app has been previously used to facilitate the application of ACT skills in diabetes management.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment iACT for Type 1 Diabetes with Eating Disorders?
The open trial of iACT for eating disorders in type 1 diabetes showed promise by teaching acceptance and mindfulness to help manage emotional distress and improve diabetes management. Additionally, a study on multidisciplinary residential treatment for type 1 diabetes and eating disorders found significant reductions in blood glucose and psychological symptoms, suggesting that tailored interventions can be effective.
12345Is iACT safe for people with type 1 diabetes and eating disorders?
The study on iACT for eating disorders in type 1 diabetes did not report any safety concerns, suggesting it is generally safe for humans.
12678How is the iACT treatment different from other treatments for eating disorders in Type 1 Diabetes?
iACT is unique because it combines Acceptance and Commitment Therapy (ACT) with a mobile app to help individuals with Type 1 Diabetes manage eating disorders by teaching acceptance and mindfulness, rather than focusing on control. This approach is tailored to address the emotional distress and unique challenges faced by those with Type 1 Diabetes, unlike conventional treatments that have been largely ineffective for this group.
128910Eligibility Criteria
This trial is for people aged 16-50 with Type 1 Diabetes who also struggle with eating disorders like bulimia or binge eating. They must manage their diabetes independently and not have a history of substance abuse, psychosis, suicidal behavior, certain other eating disorders, or be non-English speakers.Inclusion Criteria
I have been diagnosed with Type 1 diabetes.
I am between 16 and 50 years old.
Exclusion Criteria
I have been diagnosed with Avoidant Restrictive Food Intake Disorder or Anorexia Nervosa.
Participant Groups
The study tests iACT, a mobile health intervention against usual care to see which helps better with glycemic control in Type 1 Diabetics with eating disorders. Participants will be randomly assigned to one of the two groups and monitored over nine months.
2Treatment groups
Experimental Treatment
Active Control
Group I: iACT Experimental InterventionExperimental Treatment1 Intervention
Group II: Usual CareActive Control1 Intervention
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
Duke UniversityDurham, NC
Brown UniversityProvidence, RI
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Who is running the clinical trial?
Duke UniversityLead Sponsor
The Miriam HospitalCollaborator
References
An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes. [2021]Eating disorders (EDs) among individuals with type 1 diabetes (T1D) increase the risk of early and severe diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments have been largely ineffective for T1D patients, indicating the need to tailor treatments to this patient population and the unique conditions under which ED symptoms emerge (in the context of a chronic illness with unrelenting demands to control blood glucose, diet and exercise). The current study was a pilot open trial of iACT, a novel intervention for EDs in T1D grounded in Acceptance and Commitment Therapy (ACT). iACT was based on the premise that ED symptoms emerge as individuals attempt to cope with T1D and related emotional distress. iACT taught acceptance and mindfulness as an alternative to maladaptive avoidance and control, and leveraged personal values to increase willingness to engage in T1D management, even when it was upsetting (e.g., after overeating). A tailored mobile application ("app") was used in between sessions to facilitate the application of ACT skills in the moment that individuals are making decisions about their diabetes management.
Multidisciplinary residential treatment of type 1 diabetes mellitus and co-occurring eating disorders. [2021]Research on treatment for diabetes and co-occurring eating disorders is sparse. We examined outcomes from multidisciplinary residential treatment for women with type 1 diabetes and eating disorders and the impact of treatment duration on outcomes. Participants were 29 women with type 1 diabetes and eating disorders receiving residential treatment. Repeated measures analyses of variance examined changes in blood glucose and psychological symptoms over treatment. Analyses were repeated to include treatment by duration interactions. Treatment produced significant reductions in blood glucose, eating disorder symptoms, and psychological concerns. Longer treatment duration was associated with greater improvements in psychological symptoms.
Developing a novel intervention for type 1 diabetes and disordered eating using a participatory action design process: Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY). [2022]To develop a cognitive behavioural therapy-based intervention for people with type 1 diabetes and disordered eating using Experience-Based Co-Design as part of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY).
Screening for eating disorders in diabetes mellitus. [2019]Eating disorders in diabetes mellitus may be associated with serious diabetic complications. This study examines the prevalence of complications and the usefulness of the Eating Attitudes Test (EAT) in screening for eating disorders in a group of insulin-dependent diabetic women. Coping strategies for dealing with diabetes are also investigated. Increased rates of diabetic complications and insulin manipulation were confirmed among subjects with eating disorders. The EAT alone had a poor predictive value for identifying eating disorders, but the presence of raised EAT score or insulin manipulation proved effective in identifying almost all cases of eating disorder. Subjects with high EAT scores showed coping styles characterised by acceptance-resignation.
A cognitive behavioural model of the bidirectional relationship between disordered eating and diabetes self care in people with type 1 diabetes mellitus. [2022]This qualitative study aimed to develop the first cognitive behavioural therapy model outlining the development and maintenance of disordered eating in type 1 diabetes and report on recovery strategies and resilience factors to improve previous theoretical models of type 1 diabetes and disordered eating.
[Three-year follow up of metabolic control in adolescents with type 1 diabetes with and without eating disorders]. [2022]Eating disorders associated to type 1 diabetes (T1D) raise the risk of impairments in metabolic control increasing short and long term complications.
Eating disorders in individuals with type 1 diabetes: case series and day hospital treatment outcome. [2022]Women with type 1 diabetes are at high risk for eating disorders (ED), a combination that can increase medical complications and mortality. As little is known about treatment response in this population, clinical presentation and treatment outcome in an extended case series were assessed. A chart review at the Eating Disorders Day Hospital Program at Toronto General Hospital identified a total of 100 individuals with type 1 diabetes assessed 1990-2012. Of 37 who attended day hospital, most experienced improvement in ED symptoms, but only 18.8% had a good immediate treatment outcome, while 43.8% had an intermediate outcome and 37.5% had a poor outcome (meeting diagnostic criteria at discharge). This is poorer than program outcomes in individuals without diabetes (χ(2) = 12.2, df = 2; p = 0.002). Factors influencing treatment engagement and outcome must be further studied and used to improve treatment results in this high-risk group.
Treatment outcome of patients with comorbid type 1 diabetes and eating disorders. [2022]Co-morbidity between Type 1 Diabetes Mellitus (T1DM) and eating disorders (ED) has been previously described; however the effect of this illness on the outcomes for conventional ED treatments has not been previously investigated. This study aims to compare clinical, psychopathological and personality features between two samples of ED individuals: those with comorbid T1DM and those without (No-DM); and to identify differences in treatment outcomes between the groups.
Developing a theoretical maintenance model for disordered eating in Type 1 diabetes. [2016]According to the literature, eating disorders are an increasing problem for more than a quarter of people with Type 1 diabetes and they are associated with accentuated diabetic complications. The clinical outcomes in this group when given standard eating disorder treatments are disappointing. The Medical Research Council guidelines for developing complex interventions suggest that the first step is to develop a theoretical model.
Screening Practices for Disordered Eating in Paediatric Type 1 Diabetes Clinics. [2021]Type 1 Diabetes (T1D) is associated with increased risk of eating disorders. This study aimed to (1) assess adherence of Australasian paediatric T1D clinics to international guidelines on screening for disordered eating and (2) identify barriers and enablers to the use of screening tools for the identification of disordered eating.