In this week's episode of the Full of Beans podcast, Han is joined by Dr Tomos Williams. Tom has worked in the CWP Eating Disorder Service since May 2022. He works across community and specialist inpatient settings. He is the Psychiatric lead in the regional Type 1 Diabetes and Disordered Eating Clinic, the local MEED lead, and also works with patients with complex presentations, acting as a link person for local acute trusts. He is a member of the Royal College of Psychiatry Eating Disorder Faculty Executive Committee.

This week, we discuss:

• What T1DE is, and why “diabulimia” is an outdated term
• The life-threatening risks of insulin omission
• How eating disorders and diabetes treatment often conflict
• Why T1DE clinics are essential, but underfunded
• The role of eating disorder and diabetes professionals
• What joined-up, trauma-informed care looks like
• The outcomes and success of T1DE pilots
• The urgent need for political support to save these services

Timestamps:

• 01:30 – What is Type 1 Diabetes and Disordered Eating (T1DE)
• 04:00 – Medical risks associated with insulin omission
• 08:50 – Building the T1DE clinic & lack of national funding
• 13:10 – The power of a multi-disciplinary team
• 18:40 – Early signs of T1DE and what clinicians should look for
• 22:10 – Impact of trauma & perfectionism in diabetes
• 25:00 – Outcomes & HbA1c improvements
• 29:00 – Barriers to insulin pump access
• 33:20 – Can you recover from EDs while managing diabetes?

Resources & Links:

• The Compassion Project (Wessex & London T1DE Pilot)
• Parliamentary Inquiry into T1DE (2023)
• Diabetes UK on T1DE

Want to help save T1DE services?

Write to your local MP and demand continued funding. Mention the NHS England pilot outcomes and the need for integrated care for patients with type 1 diabetes and eating disorders.

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⚠️ Trigger Warning: This episode discusses lived experiences of eating disorders, restrictive behaviours, and mentions of specific foods. Please take care when listening.

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Sending positive beans your way, Han 💛