Information for the public
People with eating disorders often have other conditions too. You might have been diagnosed with anxiety or depression or have a long-term condition like diabetes. If you see different healthcare professionals for treatment, it is important that they stay in touch with each other so that they all know what is happening with your care. This is because the eating disorder could affect other treatments you are having. You might need to be checked more often for side effects caused by medicines you are taking, or a change might be needed to your treatment plan.
If you have anxiety or depression or another mental health condition, your doctor should help you decide whether you need treatment for this before your eating disorder. You might be able to have treatment for both at the same time, either combined or separately. This depends on how you feel and how quickly you need help. Your doctor can help you decide what would be best for you. You might also want to talk to your family to help you decide.
If you are misusing substances (this can include alcohol, drugs or medicines) you should still be able to have treatment for your eating disorder. If the substance misuse makes it difficult to follow your treatment, your doctor may recommend that you see a professional who specialises in helping people with substance misuse. This could be before you have treatment for your eating disorder, or while you are having the treatment.
If you have diabetes, your diabetes care team should be told that you are having treatment for an eating disorder so they can give you extra help to monitor your blood glucose. It can also be useful to involve a family member or carer in your therapy to help you. Your physical health also needs to be monitored closely. The different professionals looking after you should decide who will be responsible for this and make sure everyone involved in your care knows who this is.
For some people, the way they use their insulin becomes part of their eating disorder (this is called 'insulin misuse'). If you are misusing your insulin, your treatment should help you to address this by:
slowly increasing the amount of carbohydrates in your diet, so that you don't need to take much insulin at first
gradually increasing your insulin so that your blood glucose level falls slowly
teaching you how to adjust insulin to match the carbohydrates in your meals
teaching you about managing your diabetes and about what happens in your body when you misuse insulin.
If you have diabetes, you may be used to checking your blood glucose. However, if your specialist thinks you might have hypoglycaemia or hyperglycaemia, they may want to check your blood glucose themselves. They may also want to check your blood ketones, particularly if you are misusing your insulin. Your doctor will explain what checks you need and how often, the results of the checks, and what you should do next.
If you have bulimia and diabetes, you may need to have extra tests to make sure you are not at risk of any serious problems (such as diabetic ketoacidosis). Your doctor will explain what tests you need and how often.
NICE has written separate advice about managing diabetes. See where can I find out more?