Despite a new report this week drawing attention to the risk of T1DE, a number of pilot services for people with type 1 diabetes and eating disorders in England are at risk of closure as national funding is due to end from next month.
Type 1 diabetes with disordered eating (T1DE) is an eating disorder that only affects people with type 1 diabetes.
T1DE can be experienced in different ways. It can include forms of anorexia, bulimia or a person with type 1 diabetes reducing or not taking their insulin to lose weight.
T1DE can have different levels of severity and can be life-threatening when someone knowingly restricts the amount of insulin they take to lose weight, or to stop them from gaining weight.
Due to the complex nature of treating T1DE, specialist services were set up as pilots in England 2019. These bring together health care professionals with expertise in both diabetes, eating disorders, and mental health to give people the specialist support they need.
There are currently 5 pilot sites operating but national funding is due to end from April 2026, which means it will then be up to regional health commissioners to carry on funding the services.
While some pilot sites have managed to secure further short-term funding, there is now a significant risk that the services will start to be lost.
New report calls for better care
This comes at the same time as a new report by the Health Services Safety Investigations Body explores the risks and care available for people with mental health problems who self administer insulin, including T1DE.
The key findings include that serious dangers can occur due to mental health and diabetes services not working together, and that there is a vital need for this to change.
The recommendations include a call for a national strategy to improve collaboration between diabetes and mental health care services and points to the work Diabetes UK carried out to set out a diabetes mental health model of care.
We are calling for the Government to act on the report’s call for a strategy to improve joined up services for people with diabetes experiencing mental health problems.
Helen Kirrane, Head of Policy, Campaigns and Mobilisation at Diabetes UK, said:
“This timely report from the Health Services Safety Investigations Body must be a turning point. People living with type 1 disordered eating (T1DE) are currently at risk of losing services as NHS England pilot sites face funding uncertainty. Local commissioners must act to protect these vital services from being lost.
"Moreover, we strongly support the reports call for national commissioners to set out a clear strategy to bring diabetes and mental health services together to improve mental health care for everyone living with diabetes. Integrated, specialist care saves lives and but as the report shows this is too often not in place.”
