Type 1 Diabetes and Eating Disorders

The combination of type 1 diabetes and an eating disorder (T1DE) is ill understood with no clear nomenclature, definition or evidence base defined for management and support. It is well recognised that diabetes and mental health concerns often co-exist and type 1 diabetes per se is associated with specific self-management requirements which may predispose an individual to challenging cognitions and behaviours around food due to the nature of carbohydrate counting and insulin management.

While most diabetes teams recognise the mental health concerns around diabetes, there are few areas where multidisciplinary teams work cohesively combining diabetes care and mental health care. This is particularly relevant in the case of eating disorders where neither team are likely to be sufficiently skilled to manage the combination of type 1 diabetes and an eating disorder individually, and a strong multidisciplinary team approach with shared learning and a holistic ethos is paramount.

The ComPASSION team from Wessex have developed a multidisciplinary approach combining the specialist skills from the eating disorders teams and diabetes teams to develop a pathway for the support and management of people living with these two chronic interacting conditions leading to positive outcomes in terms of psychological and physical parameters.

We aim to introduce T1DE from a multitude of perspectives. Sara Crowley speaks eloquently on her story of living with T1DE and what she would want healthcare professionals to know and how they may talk to her about it.

Dr Lindsey Rouse is a specialist clinical psychologist in diabetes who, alongside Micki Bennet a specialist practitioner in eating disorders with a specialist interest in type 1 diabetes will look at emotional milieu of living with these co-morbid conditions and the role of language and communication in supporting people living with T1DE within the role of multidisciplinary working between physical and mental health. Dr Carla Figuereido will aim to discuss the diagnosis and clinical phenotypes of people with T1DE. Jacqueline Ryder and Nicola Stacey are diabetes specialist nurses with clinical expertise in this area and will discuss how to keep people safe when really struggling with type 1 diabetes in the context of an eating disorder and how to walk alongside and be actively supportive when people feel unable to self manage. Dr Helen Partridge (diabetes Consultant) will then lead on a Q&A session involving the multidisciplinary team.