ABSTRACT
This chapter discusses the features of eating disorders and factors that are specific to the co-morbidity of eating disorders in diabetes. Difficulties in detection and diagnosis will be described, as well as guidelines for management, highlighting common factors in treatment as well as areas where treatment diverges. A long-term follow-up study investigating insulin omission over time found that individuals with higher levels of specific distress problems with diabetes management and overall psychological distress were more likely to continue endorsing insulin omission 11 years from baseline. Management of diabetes involves increased contact with clinical services that for practical reasons often focus upon the aspects of weight, height and growth, increasing the salience of these physical attributes for the young person. The joint management of cases involving diabetes care teams and child mental health professionals is required, ideally comprising a diabetologist, a diabetes nurse, a dietitian with experience in eating disorders and/or diabetes and a psychologist.
