A dangerous feature for patients in this group is missing insulin replacement doses deliberately in an attempt to lose weight. This can trigger medical emergencies (such as diabetes ketoacidosis) and accelerates diabetes-related damage to vital organs. It is also associated with substantially increased mortality compared to people with type 1 diabetes without an eating disorder. Despite this there are, as yet, no evidence-based interventions to help manage the condition.
Dr Stadler and her colleagues aim to change this. STEADY (Safe management of people with Type 1 diabetes and Eating Disorder StudY) is a collaboration across King’s Health Partners including: the Department of Diabetes; the Diabetes, Psychiatry & Psychology Unit (King’s Institute of Psychiatry, Psychology & Neuroscience); the Diabetes Department at King’s College Hospital and the Eating Disorders Unit at the South London and Maudsley.
Over the next five years the team (including Professor Khalida Ismail, Professor Glenn Robert, Professor Janet Treasure and Dr David Hopkins) will bring together patients with type 1 diabetes and an eating disorder, doctors, nurses, psychologists and dietitians to design a programme based on patients’ lived experiences. Researchers expect this to include a mix of both diabetic and psychiatric care, with elements of education and psychotherapy.
Dr Stadler said of the collaboration: