What is T1DE (Type 1 Diabetes and Disordered Eating)?


Living with Type 1 diabetes involves both biological and psychological aspects that can increase the risk of developing an eating disorder. Some factors contributing to this heightened risk include:

  • Frequent monitoring of weight and glucose levels
  • The need for careful reading of food labels
  • Focus on weighing and food intake during medical appointments
  • The necessity to eat to address hypoglycemia (low blood sugar level)
  • Stigma and negative assumptions surrounding diabetes

Some individuals refer to the experience of having disordered eating alongside type 1 diabetes as ‘T1DE’ or ‘diabulimia,’ even though ‘T1DE’ is not an officially recognized medical diagnosis. Despite this, many people find these terms helpful.

Insulin Restriction and Other Medical Risks

For those with type 1 diabetes and an eating disorder, there may be a risk of restricting insulin to control calorie intake and weight. This can be dangerous for someone with type 1 diabetes. Other medical risks include managing hypoglycemia, starvation, and purging behaviours like vomiting, laxative misuse, and excessive exercise.

Understanding Hypoglycaemia

Hypoglycemia occurs when the blood sugar level drops too low. Symptoms may include feeling disoriented or shaky, difficulty thinking clearly, hunger, fatigue, sweating, paleness, a fast pulse, heart palpitations, or headaches. If left untreated, severe low blood sugar can lead to loss of consciousness or even death.

Psychosocial Risks

Living with type 1 diabetes and an eating disorder can disrupt various aspects of life, such as work, education, and social interactions. Social withdrawal or conflicts in relationships with family and friends may occur. Feelings of low self-worth and shame about the eating disorder are common, and there may be concerns about judgment from healthcare professionals. Seeking help is crucial, as early treatment increases the chances of recovery.

Psychological Risks

Individuals with T1DE may also experience conditions like depression, anxiety, and diabetes-related stress. Research indicates that conventional eating disorder treatments may be less effective for some people with type 1 diabetes. Treatment specifically tailored for those with eating disorders and type 1 diabetes is still in its early stages, but it is agreed that providers should have expertise in both areas.

Healthcare Professional Awareness

Healthcare professionals working with individuals with type 1 diabetes should be aware of these risk factors. Recognizing signs of an eating disorder and addressing risk factors can help prevent and intervene early in eating disorders. Using sensitive language, especially when discussing topics like weighing and glucose levels, is crucial in consultations for diabetes.