WILL AGE 5 4/16/19. Type 1 Diabetes & Eating Disorders: Navigating the Complexities of Provider- Patient Communication. Disclosure to Participants
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1 Type 1 Diabetes & Eating Disorders: Navigating the Complexities of Provider- Patient Communication Quinn Nystrom, M.S. Speaker, Author & Diabetes Advocate National Diabetes Ambassador - Center for Change WADE Conference April 26, 2019 Disclosure to Participants Notice of Requirements for Successful Completion: For successful completion, participants are required to be in attendance in the full activity and complete the program evaluation at the conclusion of the educational event. Presenter Conflicts of Interest/Financial Relationships Disclosures: No conflicts exist. Disclosure of Relevant Financial Relationships and Mechanism to Identify and Resolve Conflicts of Interest: No conflicts of interest. Non-Endorsement of Products: Accredited status does not imply endorsement by AADE, ANCC, ACPE or CDR of any commercial products displayed in conjunction with this educational activity. Off-label Use: Participants will be notified by speakers to any product used for a purpose other than that for which it was approved by the Food and Drug Administration. 2 WILL AGE 5 1
2 AGE 13 -Blood glucose meter -Blood glucose test strips -Ketone strips -Lancing device -Lancets -Continuous Glucose Monitor & Sensor -Alcohol swabs -Syringes -Insulin pump supplies -Batteries -Glucose tablets -Glucagon kit -Waterproof tape -Adhesive remover -Frio cooling wallet -Snacks 2
3 8 Camp Needlepoint 3
4 National Youth Advocate 10 Other reality 4
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7 What is ED- DMT1? The dual diagnosis of an eating disorder and type 1 diabetes is often referred to as diabulimia, however this is not a medically recognized term and it is not an accurate description. Among some academics, the nomenclature eating disorders in diabetes mellitus type 1 (ED-DMT1) is used to denote the spectrum of disturbed eating behavior found within this specific demographic. Jacqueline Allen, Birkbeck University 7
8 75% of American women are dissatisfied with their appearance. Prevalence of Eating Disorders 50% of 9 year old girls and 80% of 10 year old girls have dieted. At least 4% of teenage girls and college-age women become anorexic or bulimic. Steinhausen HC: The outcome of Anorexia Nervosa in the 20 th century. Am J Psychiatry 159: ,2002. Anorexia Nervosa and Bulimia Nervosa- Diagnosis & Treatment Guide for Professionals. ED behaviors seen in 8% of T1DM vs 1% of peers without DM. Eating Disorders + Diabetes Increased risk of disturbed eating behavior in girls with T1DM as young as % of females with type 1 diabetes have some form of disordered eating or weight control behavior. 36% reported intentional omission of insulin. Strong association between type 2 diabetes and clinically significant binge eating. Colton P et al, Eating disorders in girls and women with type 1 diabetes: A longitudinal study of prevalence, onset, remission and recurrence. Diabetes Care 38: ,July 2015 Peveler RC. Type 1 Diabetes & Eating Disorders, Diabetes Care 2005 Colton P. et al, Disturbed eating behavior and eating disorders in preteen and early teenage girls with type 1 diabetes; a case-controlled study Diabetes Care 27: , 2004 Udo et al. Menopause and metabolic syndrome in obese individuals with binge eating disorder. Eat Behav 2014;15 Feels betrayed by body with diagnosis of diabetes. Emphasis on food and dietary restraint. Why higher risk? Society setting food rules for people with diabetes. Belief that you ate your way into diabetes. Temptation factor Easy availability of deliberate insulin omission to control weight. Diabetes management focuses on numbers. Patient judges self being "good" or "bad" based on eating patterns or blood glucose level. Weight gain/higher BMI, result from intensive insulin therapy. Effect of diabetes on self-concept, body image, and family interactions. Family dynamics involving autonomy and independence concerning diabetes self-management. Diabetes Spectrum volume 22, Number 3, ,160, Mitchell, J. Medical comorbidity and medical complications associated with Bingeeating disorder. Int J Eat Dis 49:3. 8
Diabetes & Eating Disorders: A Complicated Relationship. Quinn Nystrom, M.S. Jenaca Beagley A.P.R.N., C.D.E.
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