Healthcare professional awareness of eating disorders in people with type 1 diabetes: a staff survey

Sarah Brewster, Helen Partridge, Caroline Cross, Hermione Price


Background: People with type 1 diabetes are at increased risk of eating disorders. ‘Diabulimia’, ‘Syndrome of Insulin Omission’ and ‘Type 1 diabetes and Disordered Eating’ (T1DE) are all terms used to describe the omission or restriction of insulin in type 1 diabetes for fear of weight gain. For consistency, Type 1 diabetes and Disordered Eating (T1DE) is used throughout this article. The condition is associated with a significant increase in morbidity and mortality but is not yet recognised as a unique entity.

Aim: To determine healthcare professional awareness and knowledge of eating disorders in type 1 diabetes.

Methods: A short, cross-sectional, online healthcare professional survey across primary, secondary and community settings.

Results: Healthcare professional confidence is low when it comes to recognising and supporting people with T1DE, but there is an interest in learning more.

Conclusion: The findings from this study support strategies to improve healthcare professional awareness of T1DE.


type 1 diabetes, eating disorders, diabulimia, insulin omission, healthcare professionals

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Jones JM, Lawson ML, Daneman D, Olmsted MP, Rodin G. Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study. BMJ 2000;320(7249):1563–6.

Colton P, Olmsted M, Daneman D, Rydall A, Rodin G. Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes. Diabetes Care 2004;27(7):1654–9.

Colton PA, Olmsted MP, Daneman D, et al. Eating disorders in girls and women with type 1 diabetes: a longitudinal study of prevalence, onset, remission, and recurrence. Diabetes Care 2015;38(7):1212–17.

Bryden KS, Neil A, Mayou RA, Peveler RC, Fairburn CG, Dunger DB. Eating habits, body weight, and insulin misuse. A longitudinal study of teenagers and young adults with type 1 diabetes. Diabetes Care 1999;22(12):1956–60.

Rydall AC, Rodin GM, Olmsted MP, Devenyi RG, Daneman D. Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. N Engl J Med 1997;336(26):1849–54.

Mannucci E, Rotella F, Ricca V, Moretti S, Placidi GF, Rotella CM. Eating disorders in patients with type 1 diabetes: a meta-analysis. J Endocrinol Investig 2005;28(5):417–9.

Goebel-Fabbri AE, Fikkan J, Franko DL, Pearson K, Anderson BJ, Weinger K. Insulin restriction and associated morbidity and mortality in women with type 1 diabetes. Diabetes Care 2008;31(3):415–19.

Hampshire County Council. 2011 Census: Equality and Diversity Profile- Hampshire County Council Area 2013. Available from:

Dorset Council. Topic Data. 2020. Available from:

Hampshire County Council. The 2019 Index of Multiple Deprivation. 2019. Available from:



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