Hakan Toğuç

Background Eating-related behavioural factors may contribute to the complexity of glycaemic management in type 2 diabetes mellitus (T2DM), but their relationships with treatment context remain insufficiently understood. This study examined hedonic hunger and eating-disorder symptom dimensions in relation to glycaemic control across different treatment regimens in adults with T2DM. Methods This cross-sectional study included 203 adults with T2DM attending an outpatient diet clinic in southeastern Turkey between March and September 2025. Participants were receiving oral antidiabetic medication only ( n = 108), insulin only ( n = 32), or combined oral medication plus insulin therapy ( n = 63). Hedonic hunger was assessed using the Power of Food Scale (PFS), and eating-disorder symptom dimensions using the 13-item Eating Disorder Examination Questionnaire–Short Form (EDE-Q-13). Anthropometric measurements, 24-h dietary recall data, fasting plasma glucose (FPG), and glycated haemoglobin (HbA1c) were obtained. Hierarchical linear regression was used to examine factors associated with HbA1c. Results HbA1c differed substantially across treatment groups and was highest in the insulin-only group ( p < 0.001). Several PFS subscales and EDE-Q-13 symptom dimensions also differed between groups, although their effect sizes were small. Selected PFS dimensions were weakly positively correlated with glycaemic indicators, whereas the EDE-Q-13 eating-restraint subscale and total score showed weak inverse correlations with HbA1c. In the fully adjusted model, insulin-only and combination therapy were associated with higher HbA1c compared with oral medication only, while body mass index (BMI) was inversely associated with HbA1c. Neither the PFS food available subscale nor the EDE-Q-13 total score remained independently associated with HbA1c. The final model explained 27.2% of the variance in HbA1c (adjusted r 2 = 0.230). Conclusion Treatment context was more strongly related to glycaemic status than the behavioural measures assessed, although modest differences in hedonic hunger and eating-disorder symptom dimensions were evident across treatment regimens. These findings suggest that eating-related behavioural characteristics may provide complementary information in nutritional assessment and should be interpreted alongside the broader clinical context of T2DM management.