A new InsideOut Institute guideline is supporting clinicians to better identify, prevent, assess and manage disordered eating and eating disorders in children, adolescents and adults living with Type 1 Diabetes (T1D) in NSW.

The NSW Disordered Eating and Eating Disorders in Children, Adolescents, and Adults with Type 1 Diabetes Guideline provides comprehensive, evidence-informed clinical guidance across the lifespan. Adapted from Queensland Health’s 2022 guidelines and revised by a NSW Health Working Party, the document reflects current best practice and expert consensus.

Supporting clinicians across disciplines

The guideline is designed for clinicians working in diabetes care, including medical practitioners, mental health professionals, nurses, dietitians and diabetes educators. It aims to support safe, person-centred care for individuals with T1D who may experience disordered eating or eating disorders, with a strong focus on early identification and coordinated care.

While primarily intended for diabetes clinicians, the guideline also provides useful insights for eating disorder specialists, particularly in supporting collaborative care with diabetes teams.

Key principles for care

Key principles include routine psychosocial screening to enable early intervention, interdisciplinary collaboration between diabetes and mental health teams, and a commitment to weight-neutral, stigma-free approaches to care. Treatment is encouraged to be tailored to individual needs, taking into account cultural and local service contexts.

Aligned with the NSW Service Plan for People with Eating Disorders (2021–2025), the guideline reinforces that eating disorders are core business for all NSW Health clinicians. It equips diabetes clinicians with the knowledge and language to address disordered eating safely, while promoting awareness of weight stigma and the importance of person-centred care.

A practical, team-based approach

Structured as a practical reference tool, the guideline includes sections organised by discipline to support ease of use in clinical settings. A central recommendation is the integration of mental health clinicians into diabetes teams to strengthen communication, shared decision-making, and outcomes for individuals and their families.

The focus is on outpatient and community-based care, with inpatient treatment outside the scope.

Clinical guidance highlights

The guideline outlines several key clinical recommendations, including:

• Screening for disordered eating and eating disorders at diagnosis, annually, and when risk indicators arise
• Using validated tools such as the Diabetes Eating Problem Survey–Revised (DEPS-R)
• Applying trauma-informed and culturally safe care, particularly for Aboriginal people, recognising holistic health and the impact of intergenerational trauma
• Supporting a collaborative, interdisciplinary team approach to assessment and management
• Recognising the potential misuse of insulin as a unique compensatory behaviour
• Developing individualised treatment plans that integrate medical, nutritional and psychological care

Have your say

NSW Health is inviting clinicians working with people with Type 1 Diabetes to contribute their insights via a short anonymous survey. The survey includes 11 mostly multiple-choice questions and takes approximately five minutes to complete:
https://sydney.au1.qualtrics.com/jfe/form/SV_e56WCllgY8xej6S