Support healthcare professionals to help diagnose and treat type 1 diabetes eating disorders

Healthcare professionals need better support to help recognise and treat symptoms of disordered eating in people living with type 1 Diabetes, according to new research from the University of Surrey.

Disordered eating in people living with type 1 Diabetes is often referred as T1DE. Diabulimia is one example of T1DE, a dangerous eating disorder which involves deliberate misuse of insulin for weight loss, leading to severe health problems and even death. New research from Surrey, led by Dr Katie Fitzgerald and supervised by Dr Rose-Marie Satherley, highlights the challenges healthcare professionals face in recognising and treating T1DE.

The study, published in Diabetic Medicine, has found that healthcare professionals face difficulties identifying and addressing T1DE in practice. This is due to a lack of support, limited confidence, and the fears of their patients' reactions and of damaging their patient-healthcare provider relationships. This may lead to delays in diagnosis and potentially life-threatening complications for patients.

The study found that some healthcare professionals often perceived T1DE as an “inevitable” consequence of living with type 1 diabetes, leading to a sense of helplessness. This perspective, combined with a lack of training and clear guidelines, can contribute to missed opportunities for early detection and support.

Our study highlights the need for better training and clear clinical guidelines to support healthcare professionals in addressing disordered eating in adults with type 1 diabetes. The phrase “a bit of a black hole” that was used by one participant, aptly captures the uncertainty and confusion surrounding T1DE.

There is a real fear and lack of confidence these professionals are experiencing, so we must address the intersection of physical and mental health in diabetes care. We must equip our teams with psychological-expertise, effective communication strategies, as well with the tools and support they need to have these critical conversations to help improve their patients’ health. Dr Rose-Marie Satherley, Lecturer in Clinical Psychology