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214 Cardio Diabetes Medicine 2017

diabetes and an eating disorder, such a team should Reference
include a diabetologist, a diabetes educator, a nutri- 1. Eating disorders and diabetes Volume, April 2008, Pages 179-182
tionist with training in the treatment of eating disor-
ders and diabetes patients, a psychiatrist for psycho- 2. Eating disorders in adolescent girls and young adult women with Type
1 Diabetes. Diabetes Spectrum 2002;15(2):83-105 Daneman, D et al
pharmacologic evaluation and treatment, and a men-
tal health professional to provide individual therapy. 3. Diabetes and Eating DisordersJ Diabetes Sci Technol. 2008 May; 2(3):
530–532. Published online 2008 May.
Because of the medical complexity caused by these 4. Eating patterns and type 2 diabetes risk in men: breakfast omission,
two conditions, patients with diabetes and eating dis- eating frequency, and snacking.2012 May; 95(5): 1182–1189.Published
orders require more medical monitoring than patients online 2012 Mar 28.
with diabetes alone. Medical and psychiatric inpatient 5. Dietary Patterns and the Incidence of Type 2 Diabetes ,Jukka Mon-
treatment may be needed until patients are medi- tonen Paul Knekt Tommi Härkänen Ritva Järvinen Markku HeliövaaraArpo
cally stable enough to engage in weekly outpatient Aromaa Antti Reunanen American Journal of Epidemiology, Volume 161,
Issue 3, 1 February 2005,
treatment. Monthly appointments with the diabetol-
ogist or dietitian may be necessary. Laboratory tests
(especially HbA1c.sugar values and electrolytes) and
weight checks should occur at all medical appoint-
ments and be shared with the treating mental health
professionals.

Many patients may be unable to access appropriate
treatment because it is difficult to find mental health
practitioners with both diabetes and eating disorder
treatment experience, hence diabetologist should be
well versed in both diabetes and diabetology related
psychiatry.

Take home message!!
• Diet does play a very important role in the inci-
dence and prevalence of diabetes mellitus among
the affluent population rather than the poorer sec-
tions.

• Apart from the existing known eating disorders
such as anorexia nervosa and bulimia. Which have
a direct role in the development of type 1 DM, a
new entity ‘diabulimia’ is the newest player among
the associations with DM.
• There are a lot of misconceptions about the type
of foods that can be advocated among diabetics,
foods with low glycemic index should be made
aware of and the strict implementation of this diet
should be looked into, Vegetarian food has its own
risks for the patient to develop Diabetes.

• There are certain food eating patterns that are on a
rise among established diabetics, patterns such as
‘binge eating’ and ‘sugar craving’ are being noted,
and proper dietician advice should be sought to
address this issue.
• Type 1 diabetics who suffer from associated eat-
ing disorders should be evaluated and offered
psycho-social multidisciplinary with a team of spe-
cialists from fields of diabetolgy, psychiatry and
nutrition.

GCDC 2017