Eating disorders in people with Type 1 diabetes: experiential perspectives of both clients and healthcare professionals. Issue 2 (16th December 2017)

• Record Type: Journal Article
• Authors: Macdonald, P.; Kan, C.; Stadler, M.; De Bernier, G. L.; Hadjimichalis, A.; Le Coguic, A.‐S.; Allan, J.; Ismail, K.; Treasure, J.
• Is Part Of: Diabetic medicine. Volume 35:Issue 2(2018)
• Page Start: 223
• Page End: 231
• Publication Date: 2017-12-16
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13555
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To explore the experiential perspective of people with Type 1 diabetes mellitus and eating disorders and that of the healthcare professionals treating them, and to understand the experience of both sides to inform future development of healthcare services. Methods: Participants were recruited from Diabetics with Eating Disorders (a national UK charity), and through professional networks. Nine partially/fully recovered individuals with Type 1 diabetes and eating disorders and eight healthcare professionals participated in semi‐structured interviews carried out by medically trained researchers. Data were transcribed and coded using a six‐stage framework of thematic analysis. Results: Four superordinate themes and several subordinate themes emerged from the Type 1 diabetes and eating disorders dataset: (1) perceptions surrounding service provision; (2) reflections on the recovery process; (3) the experiential perspective of living with Type 1 diabetes and an eating disorder; and (4) support mechanisms. Healthcare professional data elicited three superordinate themes and several subordinate themes: (1) service provision; (2) personal insight and reflection of professional role; and (3) challenges of working with dual diagnoses. Conclusion: People with Type 1 diabetes and eating disorders and their healthcare professionals provided insight into healthcare services from the patient and care delivery perspectives. There was general agreement from both groups that a multidisciplinary, collaborative (family inclusive), clinical approach to treatment is important, as well as adequate training opportunities for service providers. These findings may help to inform development strategies for multidisciplinary care approaches to Type 1 diabetes complicated by eating disorders. What's new: People with eating disorders and diabetes mellitus develop debilitating complications, show higher rates of disengagement from treatment teams, are harder to treat and have a higher mortality rate. Few studies have explored experiential perspectives, in terms of treatment provision, of both people with diabetes and eating disorders and healthcare professionals. The present study offers a description of the experience of the service user with both Type 1 diabetes and an eating disorder and that of their healthcare professional counterparts. Results show the need for multidisciplinary, collaborative approaches to treatment, as well as regular training and guidance for service providers and family members.