Study Reports Challenges Screening Disordered Eating in Adults With Type 1 Diabetes

Eating disorders and disordered eating are common among adults with type 1 diabetes (T1D), highlighting the need for early detection to enhance health. While screening tools for disordered eating in T1D exist, their routine use in clinical settings is uncommon. New study findings published by investigators in Diabetic Medicine aimed to assess the viewpoints and attitudes of health care providers regarding the implementation of disordered eating screening among adult diabetes care.¹

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Adolescents with T1D are more than twice likely to develop a T1D-related eating disorder (T1DE) compared with peers, causing significant mental health conditions that could lead to a threefold higher mortality risk compared with T1D alone. Early detection and intervention could improve patient results, but health care teams often report a lack of confidence in recognizing T1DE. While screening tools are available, their implementation is slow, and delayed by provider confidence and training, specifically in pediatrics. However, challenges are also present in adults with T1DE, including increased self-management and psychosocial stressors.¹

In the current study, researchers conducted a qualitative design trial with semi-structured interviews, including 13 health care professions working in the UK National Health Services (NHS) in diabetes services. The study aimed to fill the current knowledge gap by evaluating health care providers’ perspectives toward T1DE screening among adults with T1D, using a critical realism viewpoint.¹

Among the 13 providers that completed the interviews, the study authors noted that 4 themes were identified: uncertainty and inevitability of T1DE; asking about T1DE, with patients concerned regarding "overstepping the line" into eating disorder; patient-provider relationships; and lack of support for those with T1DE.¹

"Our study highlights the need for better training and clear clinical guidelines to support health care professionals in addressing disordered eating in adults with type 1 diabetes,” Rose-Marie Satherley, MD, coauthor of the study and lecturer in Clinical Psychology at the University of Surrey, said in a news release. “The phrase 'a bit of a black hole' that was used by one participant aptly captures the uncertainty and confusion surrounding T1DE.”²

The results demonstrated that health care professionals in the study found it challenging to manage the complexities of disordered eating in T1D, alongside their other responsibilities. They often viewed T1DE as unavoidable in their patient population, mentioning the constant emphasis on food in diabetes management and connecting it to external factors. Further results displayed that gender and body mass index indicators to identify T1DE could oversimplify the issue and lead to further disparities.¹

“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," Satherley said. "We must equip our teams with psychological expertise, effective communication strategies, as well as the tools and support they need to have these critical conversations to help improve their patients’ health.”²

Ultimately, the results underscore the urgent need for improved training, clear clinical guidelines, and enhanced support systems to empower health care professionals in addressing T1DE. Ultimately, bridging the gap between physical and mental health care in diabetes management is crucial to improving patient outcomes and reducing the significant mortality risk associated with T1DE.¹

REFERENCES

1. Exploring healthcare professionals' attitudes to screening for disordered eating in type 1 diabetes. Diabetic Medicine. News release. February 13, 2025. Accessed March 20, 2025. https://onlinelibrary.wiley.com/doi/10.1111/dme.70003

2. Support healthcare professionals to help diagnose and treat type 1 diabetes eating disorders. EuerkAlert!. News release. March 20, 2025. Accessed March 20, 2025.