title: Eating disorders in individuals with type 1 diabetes: case series and day hospital treatment outcome.
abstract: Women with type 1 diabetes are at high risk for eating disorders (ED), a combination that can increase medical complications and mortality. As little is known about treatment response in this population, clinical presentation and treatment outcome in an extended case series were assessed. A chart review at the Eating Disorders Day Hospital Program at Toronto General Hospital identified a total of 100 individuals with type 1 diabetes assessed 1990-2012. Of 37 who attended day hospital, most experienced improvement in ED symptoms, but only 18.8% had a good immediate treatment outcome, while 43.8% had an intermediate outcome and 37.5% had a poor outcome (meeting diagnostic criteria at discharge). This is poorer than program outcomes in individuals without diabetes (χ(2)  = 12.2, df = 2; p = 0.002). Factors influencing treatment engagement and outcome must be further studied and used to improve treatment results in this high-risk group.
authors.affiliation: Eating Disorder Program, University Health Network, and Department of Psychiatry, University of Toronto, Canada.
authors.forename: Patricia Anne
authors.initials: PA
authors.lastname: Colton
authors.affiliation: Research Associate, Eating Disorder Program, University Health Network, Toronto, Canada.
authors.forename: Marion Patricia
authors.initials: MP
authors.lastname: Olmsted
authors.affiliation: Psychosocial Oncology and Palliative Care, University Health Network, and Shirley Lederman Professor of Psychiatry, University of Toronto, Canada.
authors.forename: Harmonie
authors.initials: H
authors.lastname: Wong
authors.affiliation: Psychosocial Oncology and Palliative Care, University Health Network, and Shirley Lederman Professor of Psychiatry, University of Toronto, Canada.
authors.forename: Gary Michael
authors.initials: GM
authors.lastname: Rodin
mesh_terms: D000328:Adult; D015897:Comorbidity; D003631:Day Care, Medical; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: diabetes; eating disorder; insulin omission