Guideline to Assess and Manage Disordered Eating/Eating Disorder in Children/Adolescents/Adults with Type 1 Diabetes

Abstract

Background: The prevalence of Disordered Eating (DE) in the Type 1 diabetes (T1D) is as high as 40%, with 7% of female adolescents having an Eating Disorder (ED). The dual diagnosis confers a significant increase in morbidity and/or mortality. However, a Clinical Guideline on the best treatment approach is lacking and standard ED treatment protocols are ineffective[1]. Aim: To develop a Consensus Guideline to prevent and manage DE/ED in people with T1D across all ages, drawing on published evidence and clinical experience. Method: Current literature was reviewed following a search strategy in EMBASE, CINAHL and PsycInfo databases, using controlled vocabulary and free text search terms. Concepts focused on T1D and DE/ED and limited to English language, published in the last 10 years. An expert panel of clinicians with significant clinical and research experience in ED/DE and diabetes was established, with national representation of the Diabetes Multidisciplinary Team (Endocrinologists, General Paediatrician, Psychiatry specialising in Eating Disorders, Psychology, Dietitian, Credentialed Diabetes Educator) and consumers. The panel reached a consensus based on their clinical experience and literature search. Extensive peer review, consumer engagement/review was undertaken. Results: The Guideline was completed in August 2022 and presented at National Conferences (Australian Diabetes Society 2021, Australasian Paediatric Endocrine Group 2022, Australian Paediatric Society-International Society for Paediatric and Adolescent Diabetes 2022). It has been endorsed and published (Clinical Excellence Queensland and Australia New Zealand Paediatric Endocrinology and Diabetes Society in 2022). Conclusion: With this Guideline, there is now a document with a systematic approach to provide meaningful care that can be adapted locally. The Guideline has received much interest, is endorsed and published in Australia. It is seeking greater awareness globally.