Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes

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Overview

When you treat patients with type 1 diabetes, what clinical signs and red flags do you look for that would suggest comorbid bulimia nervosa? How should the comorbidity be treated? This narrative review summarizes the latest published evidence.

Abstract

Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa. These outcomes may be a consequence of late detection and subsequent management. The combination of these disorders has been referred to as diabulimia; however, this is not an official diagnosis and is a colloquial term used by patients and the media to describe the associated maladaptive pattern of compensatory behaviors. Early intervention is required to prevent short- and longer-term complications, with intensive treatment approaches having the best current evidence. Collaboration is required between specialist services for patients to receive optimal care. This narrative review summarizes the latest published evidence in the formulation, detection, and subsequent management of bulimia nervosa in type 1 diabetes, while highlighting the need for higher-quality research in the assessment and treatment of these comorbidities.

To cite: Yahya AS, Khawaja S, Chukwuma J, et al. Early diagnosis and management of bulimia nervosa in type 1 diabetes. Prim Care Companion CNS Disord. 2020;22(6):20nr02707.

To share: https://doi.org/10.4088/PCC.20nr02707


Read the whole article at psychiatrist.com here: 
Early Diagnosis and Management of Bulimia Nervosa in Type 1 Diabetes

© Copyright 2020 Physicians Postgraduate Press, Inc.

Target Audience

Primary care clinicians, psychiatrists

Learning Objectives

Employ a collaborative approach in the treatment of patients with bulimia nervosa and type 1 diabetes

Activity summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Activity opens: 
12/17/2020
Activity expires: 
12/31/2022
Cost:
$10.00
Rating: 
0

CME Background

Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.

CME Objective

After studying this article, you should be able to:

  • Employ a collaborative approach in the treatment of patients with bulimia nervosa and type 1 diabetes

Statement of Need and Purpose

Treatment outcomes for bulimia nervosa in type 1 diabetes are worse than those for conventional bulimia nervosa and may be a consequence of late detection and management. Early recognition and management of bulimia nervosa in patients with type 1 diabetes are needed to offer better outcomes. It is imperative that clinicians detect this comorbidity before patients’ maladaptive beliefs and disruptive behaviors become entrenched and resistant to treatment. Clinicians need education to improve awareness of this comorbidity and spur on diagnosis and treatment.

Release, Expiration, and Review Dates

This educational activity was published in December 2020 and is eligible for AMA PRA Category 1 Credit™ through December 31, 2022 . The latest review of this material was December 2020.

Disclosure of Off-Label Usage

The authors have determined that, to the best of their knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.

Funding/Support

None.

Acknowledgments

The authors thank Sherin Francis, MSc, and Folu Ojutalayo, MSc (clinical librarians, Audrey Keep Library and Knowledge Service, North East London NHS Foundation Trust, Goodmayes Hospital site, Ilford, England) for their support with the literature search. They report no conflicts of interest related to the subject of this review.

Faculty Affiliation

Ahmed Saeed Yahya, MBBS, MRCPsych*
Waltham Forest Older Adults Mental Health Team, North East London NHS Foundation Trust, Red Oak Lodge, London, United Kingdom

Shakil Khawaja, MBBS, MRCPsych
Waltham Forest Older Adults Mental Health Team, North East London NHS Foundation Trust, Red Oak Lodge, London, United Kingdom

Jude Chukwuma, MBBS, MRCPsych, DPM, MD
Barnet, Enfield and Haringey Mental Health Trust, London, United Kingdom

Chisolum Chukwuma MBBS, MRCGP
Babylon Health Office, London, United Kingdom

*Corresponding author: Ahmed Saeed Yahya, MBBS, MRCPsych, Waltham Forest Older Adults Mental Health Team, North East London NHS Foundation Trust, Red Oak Lodge, London, E11 4HU, United Kingdom (a.yahya@nhs.net).

Financial Disclosure

All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Larry Culpepper, MD, MPH, Editor in Chief of The Primary Care Companion for CNS Disorders, has been a consultant for Acadia, Allergan, Eisai, Merck, Supernus, and Takeda; has been a stock shareholder of M-3 Information; and has received royalties from UpToDate and Oxford University Press. No member of the CME Institute staff reported any relevant personal financial relationships.

Drs Yahya, Khawaja, J. Chukwuma, and C. Chukwuma have no personal affiliations or financial relationships with any commercial interest to disclose relative to the article.

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this journal-based CME activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation

Price

Cost:
$10.00
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