Chicago Tribune Oct. 2013
Walden Behavioral Care, LLC, which operates an eating disorder clinic in South Windsor, has created the Type 1 Diabetes Eating Disorder Program, the first in-patient program in New England developed to treat patients with type 1 diabetes who have an eating disorder.
The program will offer both in-patient and residential care for adolescents 12 and older and adults at its Waltham, Mass., facilities.
Studies show that women with type 1 diabetes are more than twice as likely to have eating disorders as those who do not have diabetes.
“Considered individually, type 1 diabetes and eating disorders are life-threatening illnesses,” according to President and CEO Stuart Koman, Ph.D. “Considered together, they are among the most challenging illnesses we can face.”
For example, patients with eating disorders must overcome an ongoing obsession with food, yet treatment of diabetes requires that patients pay strict attention to what and how much they eat.
In addition to having anorexia, bulimia or binge-eating disorder, people with type 1 diabetes also frequently skip or restrict insulin doses. Although often referred to as “diabulimia,” the practice is not a form of bulimia.
“My research indicates that 30 percent of girls and women with type 1 diabetes skip or reduce necessary insulin injections to lose weight,” said Ann E. Goebel-Fabbri, Ph.D., a clinical psychologist at Joslin Diabetes Center and a leading researcher on diabetes and eating disorders. “Doing so routinely can triple their risk of death.”
Restricting insulin causes diabetic ketoacidosis (DKA), which can be fatal. Symptoms include vomitting, dehydration, difficulty breathing and confusion. The individual may also become comatose.
Lack of proper insulin dosing can also result in a higher likelihood of diabetes complications, such as blindness, nerve damage and kidney disease.
Recognizing that patients with type 1 diabetes and eating disorders would benefit from a program that treats both illnesses together, Walden created the Type 1 Diabetes Eating Disorder Program. As a first step, Walden arranged to have medical, nursing and nutrition staff trained by Joslin staff so that they could help patients better manage their diabetes even while treating their eating disorder. In addition, Walden has arranged to have type 1 diabetes patients who participate in the program evaluated at Joslin Diabetes Center. After evaluating the patient, the Joslin physician will develop a diabetes treatment plan for Walden staff to follow while the patient’s eating disorder is being treated at Walden.
The Joslin doctors will also work and consult with each patient’s endocrinologist, and Walden staff will have 24-hour access to consulting endocrinologists from Joslin. With ongoing communication, this team approach will ensure coordinated, efficient treatment, according to James M. Greenblatt, M.D., medical director of Eating Disorder Services.