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"It's time to get the experts together, not only to review the research,but to learn from each other," says Richard Bergenstal, MD, Executive Directorof the International Diabetes Center at Park Nicollet, and co-host of theconference.
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Panelists include Ovidio Bermudez, MD from the Laureate PsychiatricHospital in Tulsa; Gary Rodin, MD from Toronto; William Polonsky, PhD, of theBehavioral Diabetes Institute at the University of California, San Diego;Patricia Colton, MD from Toronto General Hospital; Scott Crow, MD from theUniversity of Minnesota; Ann Goebel-Fabbri, PhD, from the Joslin DiabetesCenter in Boston; and Juliet Zuercher, RD, from Remuda Ranch Treatment Centersin Phoenix.
What is "diabulimia"?
The public calls it "diabulimia" and clinicians call it "Dual Diagnosis."Either term describes the potentially deadly combination of diabetes andeating disorders. Patients withhold insulin injections-the drug they need totreat type 1 diabetes-so their bodies will pass the sugars and carbohydratesthey eat without processing them. It may make them thin in the short run, butover time it can lead to increased rates of blindness, loss of limbs, kidneydisease, heart disease and death. Research shows the mortality rate is 33%(Mortality in Concurrent Type 1 Diabetes and Anorexia Nervosa, Diabetes Care25:309-312, 2002).
Currently there is no established best-practice protocol for treatment.Patients often go back and forth between specialists in the two areas withlittle or no coordination. Park Nicollet Health Services-one of the firsthealth systems in the nation to develop a comprehensive combined treatmentprogram-is determined to change that by hosting an international conference toestablish new standards for treatment of eating disorders and diabetes. "Wewant to bring together a team of experts and establish guidelines for thetreatment of this potentially lethal illness," says Joel Jahraus, MD,Executive Director of the Park Nicollet Methodist Hospital Eating DisordersInstitute.
"There is great irony in a dual diagnosis," says Dr. Bergenstal. "Ourdiabetes patients are taught to count carbohydrates and calories and keeptrack of what they're eating. But doing that may also trigger an eatingdisorder." That medical catch-22 is one of the many unique challenges thatexperts will wrestle with this fall.
"Recently we've seen an increase in numbers of individuals with dualdiagnosis illness seeking treatment at the Eating Disorders Institute and theInternational Diabetes Center," says Dr. Jahraus. "This has caused us tocollaborate internally and rethink our approach to the dual diagnosis of aneating disorder and diabetes. Now is the time to bring together a largeraudience of clinicians and researchers to develop useable, comprehensivetreatment plans. It just can't wait any longer."
International Diabetes Center at Park Nicollet provides world-classdiabetes care, education and clinical research to meet the needs of peoplewith diabetes, their families and the health professionals who care for them.Located in suburban Minneapolis, the center is recognized internationally forits range of clinical and educational programs, products and services.International Diabetes Center is part of Park Nicollet Institute, a divisionof Park Nicollet Health Services.
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