Treatment for Comorbid Diabetes and Dysregulated Eating

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Once an eating disorder or any pattern of disordered eating is diagnosed, treatment should begin immediately. Patients may require inpatient treatment in either a medical or psychiatric hospital, if their eating disorder is particularly severe, or their health is at immediate risk. An example of this circumstance, which is most relevant to people with diabetes, is a person who has intentionally omitted so much insulin from their regimen that they have entered a state of ketosis and require an intravenous insulin drip in order to normalize their blood sugar.

After immediate physical danger has been eliminated or ruled out, long-term treatment can begin. Because of the increased risks associated with having both DM1 and an eating disorder, an interdisciplinary team should be utilized in order to address the complex nature of the problem. Ideally, the team should include a psychotherapist, diabetes educator, endocrinologist, and nutritionist. These professionals should be in regular communication with each other in order to ensure that treatment is progressing; and the physical, emotional and psychological needs of the patient are all being addressed. Depending on the age and circumstances of the patient, family, group, and/or couples therapy may be appropriate as well.

One small study compared 9 young women with bulimia nervosa who were receiving in-patient treatment to 10 young women with bulimia nervosa who were not. These patients were reassessed 3 years after treatment by examining their body mass index, HbA1c results, and psychological test scores. Patients who had received inpatient treatment had lower HbA1c results and demonstrated lower scores on measures assessing depression, anxiety, and binge eating and purging behaviors (80). Although the small sample size of this study makes it difficult to discern how generalizable the results are, these preliminary findings do suggest that inpatient treatment may be a more helpful form of treatment for women with diabetes who are suffering from bulimia nervosa.

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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