Diabetes and Eating Disorders: Diabulimia

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Patients with eating disorders and those with diabetes have two very different sets of nutritional and medical needs. When someone has both conditions—sometimes referred to as diabulimia when they are restricting insulin—care becomes much more complex. In fact, complications like diabetic ketoacidosis can become life-threatening, and longer-term damage can include serious problems like kidney failure. A multidisciplinary approach is essential for effective treatment.

Princeton Center for Eating Disorders offers a multidisciplinary, evidence-based protocol for the comprehensive treatment of children and adults with type 1 diabetes and an eating disorder. The diabulimia care plan brings together insight from five areas: nursing, nutrition, therapy, psychiatry, and endocrinology.


Care is structured to help patients build the tools and knowledge necessary to work toward recovery from the eating disorder while managing their diabetes independently—skills they will need upon discharge. Overall progress is organized in a tier system, and as patients develop skills in each level, they move toward greater independence.


The treatment protocol for those with eating disorders and diabetes/diabulimia includes:


Medical stabilization and care: Patients have onsite access to medical specialists and endocrinologists at Princeton Medical Center upon admission and throughout their stay as needed.


Psychiatric care: Board-certified psychiatrists specializing in eating disorder treatment provide individualized behavioral health care and medication oversight.


Nursing oversight: Nurses help manage patient care, regularly monitor blood sugar levels, and provide continual education on diabetes and its management.


Nutrition management: Dietitians work with patients to monitor calorie intake and carbohydrate balance while educating them about nutrition needs and menu planning. With this knowledge, patients advance from checking off preselected menu items to writing in their preferences.


Therapy: Through individual and group therapy, therapists help patients with diabulimia build coping skills, regulate emotions, and manage urges to withhold insulin. The team has developed a system for tracking mood and other parameters, including changes in blood sugar.


Patient and family education: Diabulimia education is integrated throughout care, with topics like diabetes and nutrition, managing emotional stress, and the impact of blood sugar levels on mood. Effective communication with family members also is an important component of the program.


Princeton Center for Eating Disorders is the only program in the Mid-Atlantic region to offer this level of multidisciplinary care for patients as young as 8 years old living with diabulimia.


Princeton Center for Eating Disorders provides acute, inpatient care for children and adults with eating disorders and other medical and psychiatric conditions, including all forms of diabetes.
Princeton Center for Eating Disorders