Type 1 Diabetes and Eating Disorders: The Importance of Healthcare Provider Knowledge of Eating Disorders in Type 1 Diabetes

Type 1 diabetes affects more than 3 million people in the United States and the rate of incidence is increasing on a global level (Atkinson, 2014). The diagnosis of type 1 diabetes often occurs prior to or during adolescence and the disease requires a high level of self-management. Adolescence is a challenging time for many adolescents especially in regards to body changes, weight gain and body image. Due to the added burden surrounding food with type 1 diabetes, disordered eating is more likely to occur. The rate of eating disorders in individuals with type 1 diabetes is as much as two times higher than that of their nondiabetic counterparts. Eating disorders and type 1 diabetes can lead to poor clinical outcomes including neuropathy, nephropathy, retinopathy, and even death. Often the presence of an eating disorder is not known until those complications develop, and there is little that can be done to reverse the damage. It is difficult for healthcare providers to detect eating disorders in those with type 1 diabetes due to a lack of education, training, and criteria to diagnose. The goal of this project is to review existing literature for eating disorders among individuals with type 1 diabetes. This literature review also addresses the lack of current diagnostic criteria for the diabetes-specific eating disorder, diabulimia, creating a gap in knowledge for many healthcare professionals. Very few guidelines and support are provided for healthcare providers, therefore an approach on how primary care providers and endocrinologists can better address the need of individuals with type 1 diabetes and eating disorders is presented.