Recognising and managing type 1 disordered eating in children and young people with diabetes

Type 1 disordered eating (T1DE), also referred to as diabulimia, is a serious eating disorder that can occur in children and young people with type 1 diabetes when they deliberately reduce or restrict their insulin doses to lose weight. It is highly dangerous and can cause serious short-term conditions such as diabetic ketoacidosis, as well as various long-term comorbidities. T1DE is challenging to identify, and diagnosis is based on a range of emotional, behavioural and physical signs and symptoms. There is also a lack of research on how to support children and young people with the condition. This article aims to increase awareness of T1DE among children's nurses and to explain the role of the multidisciplinary team in diagnosis and treatment. It outlines the pathophysiology and signs and symptoms of T1DE and discusses how healthcare professionals, including nurses, can support children and young people with the condition.