ABSTRACT
Chapter 13 focuses specifically on type 1 diabetes mellitus and concurrent eating disorders, also called ED-DMT1 or diabulimia. It reviews the two main types of diabetes, type 1 and type 2, and why patients can develop microvascular complications such as stroke, heart attack, retinopathy, neuropathy, kidney failure, and limb loss (amputation), as well as recurrent diabetic ketoacidosis. Patients who omit insulin lose weight through various mechanisms related to hyperglycemia, or high blood glucose, and this can prove to be a gateway into an eating disorder as well as causing significantly higher morbidity and mortality rates. Those with ED-DMT1 have significantly higher hemoglobin A1c levels. Overly rigid diabetes care practices can cause recurrent hypoglycemia and treatment burnout and can lead to a disordered relationship with food and health numbers. The edema that develops when a patient with ED-DMT1 resumes using adequate doses of insulin may be triggering and a major barrier to recovery. Good treatment can minimize the development of edema and improve the patient experience.
