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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2015; 6(3): 517-526
Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.517
Eating disorders in adolescents with type 1 diabetes: Challenges in diagnosis and treatment
Orit Pinhas-Hamiel, Uri Hamiel, Yael Levy-Shraga
Orit Pinhas-Hamiel, Uri Hamiel, Yael Levy-Shraga, Pediatric Endocrinology and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Ramat-Gan 52621, Israel
Orit Pinhas-Hamiel, Uri Hamiel, Yael Levy-Shraga, Sackler School of Medicine, Tel-Aviv University, Juvenile Diabetes Center, Maccabi Health Care Services, Ramat-Gan 52621, Israel
Author contributions: Pinhas-Hamiel O, Hamiel U and Levy-Shraga Y performed literature review, wrote the paper, and conceived the three level models and created the graphs.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Orit Pinhas-Hamiel, Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children’s Hospital, Sheba Medical Center, Tel Hashomer, Ramat-Gan 52621, Israel. orithami@sheba.health.gov.il
Telephone: +972-3-5305015 Fax: +972-3-5305055
Received: August 27, 2014
Peer-review started: August 28, 2014
First decision: November 27, 2014
Revised: December 9, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: April 15, 2015
Processing time: 236 Days and 8.2 Hours
Core Tip

Core tip: Intentional insulin omission for the purpose of preventing weight gain is a unique behavior available to individuals with type 1 diabetes mellitus (T1DM). It is classified as either an inappropriate compensatory feature of bulimia nervosa or as a purging disorder component of other specified feeding or eating disorder (ED). Its prevalence increases with age, affecting up to 40% of young adult females with T1DM. The comorbid of ED in T1DM patients is associated with higher rates of short and long-term diabetes complications. A high index of suspicion is needed since ED behaviors are often well hidden and denied. Treatment involves a complex interplay of psychosocial, dietary and medical aspects and requires a multidisciplinary team.