Exploring healthcare professionals' attitudes to screening for disordered eating in type 1 diabetes

Eating disorders and disordered eating behaviours are prevalent among adults with type 1 diabetes, making early identification essential for improving health outcomes. Although screening tools exist to detect disordered eating in type 1 diabetes (T1DE), their application in clinical practice remains limited. This study investigates healthcare professionals' perspectives and attitudes towards screening for disordered eating in adult diabetes services.

This qualitative study employed semi-structured interviews with 13 healthcare professionals from adult diabetes services. Purposive sampling was used to ensure a broad range of healthcare professional viewpoints. The interviews centred on their perceptions of screening for disordered eating in type 1 diabetes.

Reflexive thematic analysis was used to identify four themes: (1) Uncertainty and Inevitabiltiy of T1DE: 'A bit of a black hole', (2) Asking about T1DE: 'My fear is…am I overstepping the line', (3) Patient-provider relationships: 'A backward step', and (4) Lack of support for T1DE: 'Where do you go?'. While healthcare professionals recognised the link between diabetes management and disordered eating, they lacked confidence in screening for these challenges due to limited time and the scarcity of specialist disordered eating resources for type 1 diabetes.

This study highlights the challenges healthcare professionals face in screening for disordered eating in type 1 diabetes. By highlighting the need for enhanced training and clear clinical guidelines, this research suggests pathways to improve healthcare professional confidence in addressing these critical conversations with patients, ultimately supporting better health outcomes.