new Brazilian Guidelines Emphasize Integrated Care for Eating Disorders in Diabetes
RIO DE JANEIRO, BRAZIL – The brazilian Society of Diabetes (SBD) has released new guidelines addressing the often-underdiagnosed and devastating intersection of eating disorders and diabetes, especially Type 1 Diabetes (DM). The guidelines, released recently, stress the critical need for a multidisciplinary approach to treatment, moving beyond isolated specialty care to a fully integrated model.
Eating disorders in individuals with diabetes, termed “diabetes-associated disordered eating behavior” (DADEB) or, more specifically, “atypical eating behaviors in diabetes” (TAS), present unique challenges due to the interplay between metabolic control and psychological factors. The SBD highlights that these disorders are frequently missed, leading to severe health consequences.
The updated recommendations call for continuous surveillance of patients with diabetes, extending beyond traditional metabolic parameters to include regular evaluation of emotional and behavioral aspects. Weight fluctuations, worsening glycated hemoglobin levels, and anxiety surrounding food intake are identified as potential relapse indicators requiring immediate attention. Long-term success, the guidelines state, hinges on structured and integrated follow-up care.
Effective treatment necessitates collaboration between endocrinologists, nutritionists, psychologists, psychiatrists, and other relevant healthcare professionals. the SBD emphasizes that relying on a single specialty is insufficient; a multiprofessional model where expertise complements itself – encompassing endocrinology, psychology, nutrition, and psychiatric support with medication when needed – is essential for successful treatment of TAS in individuals with DM.
The guidelines urge healthcare providers to incorporate TAS tracking into routine diabetes consultations and adopt a holistic approach considering both physical and mental wellbeing. Psychotherapy is identified as a core component of treatment, alongside dietary plans focused on flexibility and sustainability rather than restrictive prohibitions. Endocrinologists are encouraged to prepare for the complexities arising from the intersection of diabetes pathophysiology and the psychodynamics of eating disorders.
Recognizing the unequal access to mental health services in Brazil, the SBD calls for strategies to integrate care, including training for primary care teams, utilizing telemedicine to expand access, implementing simple screening protocols, and raising awareness among healthcare professionals about the importance of this frequently enough-overlooked issue. The SBD believes this integrated approach can significantly improve patient outcomes, prevent early complications, and transform diabetes care for vulnerable individuals.
