{"id":1472,"date":"2023-06-02T13:37:44","date_gmt":"2023-06-02T12:37:44","guid":{"rendered":"https:\/\/sites.manchester.ac.uk\/reval\/?page_id=1472"},"modified":"2026-03-03T14:39:39","modified_gmt":"2026-03-03T14:39:39","slug":"t1de","status":"publish","type":"page","link":"https:\/\/sites.manchester.ac.uk\/reval\/current-evaluations\/t1de\/","title":{"rendered":"T1DE"},"content":{"rendered":"

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\nREVAL<\/a><\/span><\/span>
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Evaluation of integrated diabetes and mental health services to support patients with Type 1 diabetes related disordered eating (T1DE)<\/h1>\n

Please see the link to the full evaluation report here.<\/a><\/p>\n

Background<\/h2>\n

The management of Type 1 diabetes can make individuals more vulnerable to disordered eating behaviours. Insulin restriction or omission as a purging behaviour to control body weight is of particular concern as it is associated with increased morbidity and as much as a threefold increase in mortality.<\/p>\n

This is a clinical issue that cuts across both the mental health and diabetes disciplines, but one which requires a different approach to the traditional treatment methodologies of both conditions.<\/p>\n

In response to growing recognition of unmet need, NHS England commissioned a pilot of two exploratory Type 1 diabetes disordered eating services, with the aim of developing the evidence base around how best to manage this high-risk cohort by testing an integrated diabetes and mental health pathway.<\/p>\n

However, as the pilot implementation and evaluation were conducted during the COVID-19 pandemic, this combined with the relatively small amount of participant data available means that limited conclusions could be drawn.<\/p>\n

What we are doing<\/h2>\n

Our overall aim is to provide a clinically robust, high-quality evaluation is required to determine how the NHS can best support patients with Type 1 diabetes related disordered eating.<\/p>\n

We will conduct a multi-site, multiple-methodologies study, conducting interviews with staff, wider stakeholders and service users who are either delivering or in receipt of the T1DE service.<\/p>\n

We will:<\/p>\n

    \n
  1. Describe service delivery models and how they were developed and are evolving.<\/li>\n
  2. Investigate whether service implementation is being achieved (compared against service specifications) and in a way that is acceptable to staff. We will explore contextual factors that contribute to implementation progress.<\/li>\n
  3. Investigate how service delivery is being sustained, exploring any adaptations made to services over time with the aim of supporting ongoing activity and enhancing service delivery.<\/li>\n
  4. Investigate the experiences of service users.<\/li>\n
  5. Explore the costs of the service against the clinical consequences for service users.<\/li>\n<\/ol>\n

    The protocol for this evaluation can be found here.<\/a><\/p>\n

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