The Duke Diabetes Research Team is committed to enhancing the lives of individuals with Type 1 Diabetes (T1D). We do so through clinical practice, advocacy and research. In our studies, we investigate factors that contribute to difficulty managing eating and insufficient insulin and develop and test novel treatments. 

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Disordered eating behaviors are fairly common among individuals with T1D and exist on a continuum. At any level, behaviors such as restricting food, overeating or binge eating, or taking less insulin than is needed because of concerns about weight can interfere with management and increase risk of diabetes-related medical complications. One of the most dangerous eating disorder symptoms is the intentional withholding of insulin. This may be referred to as "ED-DMT1" or sometimes "diabulimia." It is important for treatment providers to understand both the complexities of disordered eating as well as type 1 diabetes.  

Health Risks of Insulin Restriction:

• High glucose levels               

• Glucose in the urine

• Exhaustion

• Thirst

• Inability to think clearly

• Severe dehydration

• Muscle loss

• Diabetic Ketoacidosis - DKA (unsafe levels of ketones in the blood)

• High Cholesterol

• Bacterial skin infections

• Yeast infections

• Menstrual disruption

• Staph infections

• Retinopathy

• Neuropathy

• Peripheral Arterial Disease

• Atherosclerosis (a fattening of the arterial walls)

• Steatohepatitis (a type of liver disease)

• Stroke

• Coma

• Death

Possible signs of disordered eating behavior can include:

• Hemoglobin A1C level of 9.0 or higher on a continuous basis.

• Unexplained weight loss.

• Persistent thirst/frequent urination.

• Preoccupation with body image.

• Reactivity to weighing.

• Blood sugar records that do not match Hemoglobin A1c results.

• Depression, mood swings and/or fatigue.

• Secrecy about blood sugars, shots and or eating.

• Repeated bladder and yeast infections.

• Low sodium/potassium.

• Increased appetite.

• Cancelled doctors' appointments.

Please consider signing up for our Registry. Individuals on the registry receive notifications for studies for which they may be eligible. 

Note: Anyone with T1D is encouraged to join our registry - our studies involve individuals with and without eating disorders.