Diabetes and Eating Disorders: Double the Complications
by Marcia Meier, BAN, RN, CDE
Eating Disorders Institute
Over the past several decades, researchers have studied the fascinating — and dangerous — link between type 1 diabetes and eating disorders. Today, strong evidence suggests that eating disorders are more common in patients with type 1 diabetes than in those without this disease.
Skipping insulin to stay thin
"When people with type 1 diabetes discover they can lose weight by not taking insulin, they may skip it so they can eat anything they want and not gain weight," says Marcia Meier, registered nurse and certified diabetes educator at International Diabetes Center at Park Nicollet. "Those who manipulate insulin range from teens to 50 year olds and often have traits common to those with eating disorders."
These traits may include a perfectionist attitude and an intense desire to please others. They also may have low self-esteem and mood disorders, such as anxiety, depression and obsessive-compulsive disorders. In addition to common eating disorder behaviors such as withholding food, binging and purging and excessive exercise, patients with the dual diagnosis of an eating disorder and type 1 diabetes are able to figure out that by withholding insulin, they can lose weight.
Double the risks
It's extremely dangerous to manipulate insulin. Without it, blood sugar rises, increasing the potential for diabetes-related complications. These may include heart disease, kidney failure, neuropathy, and foot and eye concerns. In addition, eating disorders themselves can lead to serious health conditions and even premature death. "People with this dual diagnosis can end up with serious health concerns earlier in life than those with diabetes alone," Meier says.
Treating both conditions
International Diabetes Center and Methodist Hospital Eating Disorders Institute have joined efforts to treat patients with type 1 diabetes and eating disorders. "We haven't found any other program in which two nationally known specialty programs are collaborating to treat a dual diagnosis," Meier says. "In fact, members of our team are sharing our expertise with other care providers throughout the country."
The care team includes an endocrinologist, internist, diabetes nutrition educator, diabetes nurse educator, psychologist and psychiatrist. In addition, a nurse care manager helps coordinate treatment, keeps communication consistent and answers questions for patients and families. Patients have a range of inpatient and outpatient options available at the Eating Disorders Institute that take patients through all phases of treatment. Although only a small percentage of people have this dual diagnosis, this combined approach has proven invaluable for helping patients overcome the physical and psychological components of an eating disorder and type 1 diabetes.
To learn more about this dual diagnosis or to schedule an appointment, call 952-993-6200 or visit Eating Disorders Institute.
