Specialist Type 1 and eating support at risk: where things stand
National NHS England funding for five specialist type 1 diabetes and disordered eating pilot services ends in April 2026, leaving their future unclear.
If you live with Type 1 and a hard relationship with food, this is worth knowing, and it is not a reason to panic. Five specialist NHS services in England that support people who have both Type 1 and disordered eating, known as T1DE services, are losing their national funding from April 2026. After that, whether each one continues is down to local NHS commissioners, the bodies that decide what gets funded in an area. The services have not closed, and support for you has not gone away.
- T1DE services join up two things usually kept apart: your diabetes care and support for eating and mental health, in one place and one team.
- Disordered eating with Type 1 can include restricting insulin to affect weight. It is more common than people admit, and it is treatable, not shameful.
- The change is about national funding ending in April 2026, not an immediate closure. What happens next varies from region to region.
- If food and diabetes feel tangled up right now, you can ask for help today, from your diabetes team or GP, without waiting for any of this to be settled.
- You are not alone in this, and reaching out is not an overreaction.
What the funding decision actually says
There are currently five T1DE pilot sites running in England. National NHS England funding for them is due to end from April 2026, and after that it becomes the job of regional health commissioners to decide whether to keep paying for the services in their area. That is the whole of the change: the money that set them up nationally stops, and their future then rests on local decisions.
This matters because these pilots were built to fill a real gap, and letting them lapse would leave people without a service that is hard to replace. Diabetes charities have flagged the uncertainty rather than a confirmed shutdown, so the honest picture right now is unsettled, not decided.
Why joined-up support is the point
Diabetes and disordered eating pull against each other, and treating them in separate rooms often fails. A standard eating-disorder service may not understand insulin, and a standard diabetes clinic may not have the time or training for the eating side. A T1DE service holds both at once, so you are not bounced between teams or made to explain a hypo to someone who has never dealt with one.
None of this is about willpower or blame. Managing food, numbers and insulin every single day is a heavy load, and for some people that load tips into a difficult or dangerous relationship with eating. Wherever you live, and whatever happens to these particular pilots, that is a legitimate thing to ask for help with, and asking early makes it easier to help you.
Getting support now
Questions that make an appointment useful
When it's urgent
If things ever feel like too much, support is there right now, and you do not have to wait for a referral. You can call Samaritans free on 116 123 at any time, or text SHOUT to 85258 to message a trained volunteer. If you or someone else is in immediate danger, call 999. Reaching out early is a strength.
Restricting insulin lets glucose climb, and if you ever feel unwell with a high reading and are being sick, drowsy, breathing heavily or fast, have stomach pain, or notice breath that smells fruity, that can be diabetic ketoacidosis (DKA), a medical emergency. Call 999 or get to hospital straight away, and do not let checking anything delay the call.