The practical management of patients with type 1 diabetes requiring in-patient care due to an eating disorder

Abstract

Young women with type 1 diabetes are at twice the risk for the development of an eating disorder compared with their peers. When an eating disorder co-exists with diabetes there is an increased risk of earlier onset of diabetes-related complications as well as more severe complications. There is limited knowledge of how to detect eating disorders in individuals with diabetes and how best to manage the condition. This paper discusses our experiences in managing young adults, with type 1 diabetes and an eating disorder, at the specialist in-patient level where team members are experienced in managing both illnesses. We highlight specific management issues at the in-patient level and present a case example. It is challenging to manage such patients because the day-to-day management issues of diabetes often tend to overwhelm psychiatric interventions, particularly if eating disorder staff are less experienced in diabetes management. As psychiatric issues are difficult to manage by the diabetes team, the needs of a young adult with diabetes and an eating disorder are hard to meet. Addressing diabetes specific concerns as well as weight and shape concerns is essential, as is a well co-ordinated management team addressing both eating disorders and diabetes. Copyright © 2005 John Wiley & Sons, Ltd.