Type 2 Diabetes and Binge Eating Disorder (BED)

This outcome will assess changes in the number of binge eating episodes per week among participants receiving BED treatment compared to baseline

BED-Q is a questionnaire consisting of 10 items, with questions 1-7 assessed on a Likert scale from 0-5. Together, these questions constitute a score ranging from 0-35, indicating the severity of Binge Eating Disorder (BED) from none to mild, moderate, severe, and extreme. The items in BED-Q are carefully crafted to reflect the diagnostic criteria for Binge Eating Disorder (BED) according to DSM-5, including (1) episodes of binge eating large amounts of food in a short period (within two hours); (2) a sense of losing control over eating; (3) eating faster than usual; (4) eating until uncomfortably full; (5) eating when not hungry; (6) eating alone; and (7) experiencing negative emotions such as guilt or shame after binge eating. Question 8 is used to screen for any compensatory behaviors, such as vomiting, while questions 9 and 10 examine the distress associated with binge eating episodes.

Glucose sensor data will be collected using continuous glucose monitoring devices to assess blood glucose profiles during the first week and the last week of the treatment period. This non-invasive method captures real-time glucose levels over time, providing insights into glucose variability and trends. The collected data will aid in evaluating the effectiveness of the intervention in managing blood glucose levels and overall glycemic control.

HbA1c, or glycated hemoglobin, levels are measured as a blood sample (2 ml) to assess long-term blood sugar control. This measure reflects average blood glucose levels over the past two to three months, and lower HbA1c levels indicate better glycemic control.

EDE-Q is a self-report questionnaire used to assess symptoms of eating disorders, particularly anorexia nervosa, bulimia nervosa, and Binge Eating Disorder (BED). It comprises various questions covering areas such as eating disorder symptoms, eating behaviors, and thoughts about body and weight. Participants complete the questionnaire to provide information about their eating patterns and body image.

The Major Depression Inventory (MDI) is a self-report questionnaire designed to assess the presence and severity of symptoms of major depression. It consists of 10 questions covering various aspects of depression, such as mood, energy level, concentration, sleep patterns, and appetite changes. Participants respond to the questions using a 6-point Likert scale ranging from 0 to 5. The total score ranges from 0 to 50, with a higher score reflecting more symptoms of depression.

PAID20 is a validated and extensively tested 20-item questionnaire that quantifies the emotional burden experienced by individuals with diabetes. This includes feelings of guilt, frustration, worry, and self-blame related to their diabetes. PAID questions are measured on a 5-point Likert scale with response options ranging from 0 to 4. PAID20 has demonstrated sensitivity to changes over time, making it suitable for evaluating the impact of therapeutic interventions and treatments in individuals with diabetes.

Lipid profile assessments is measured as a blood sample (3 ml) and includes various blood lipid levels; cholesterol, triglycerides, and lipoproteins. Cholesterol levels, including HDL (high-density lipoprotein) and LDL (low-density lipoprotein), are evaluated to assess lipid metabolism and cardiovascular risk.

BMI will be calculated as an outcome measure by combining weight (measured in kilograms) and height (measured in centimeters). BMI is calculated by dividing weight by the square of height. Participants are provided with blinded weighings, as weight loss is not the target of our intervention.

Blood pressure assessments will be conducted to evaluate cardiovascular health. Measurements will include systolic and diastolic pressures, recorded in millimeters of mercury (mmHg), to assess overall cardiovascular function and risk of cardiovascular disease