Although most likely unrelated to the eating disorder difficulties described here, one rare complication of poorly controlled type I diabetes was reported in the medical literature from the 1930s at least through the 1980s, called Mauriac syndrome. The children were not only underweight, but exhibited short stature as well (and liver enlargement plus some other endocrine signs). Because of its rarity, it may be unknown by more than a generation of pediatricians, There was no description of "intentional" or behaviorally disordered eating in the literature on Mauriac syndrome, but in general, the children were described as having longstanding, poorly controlled diabetes. Their eating habits might have been relatively unknown or poorly characterized. They were most often adolescents, just as are the patients described here.
A diabetic child who is markedly underweight and living in a setting of inadequate or non-existent regular medical care might merit evaluation for this broader complication, and should not be assumed to have weight loss due to disordered eating.
I learned about this rare condition almost 40 years ago, in medical school at the Riley Children's Hospital in Indianapolis. Sometimes, it only takes one case for a very rare condition to stick in the memory of a physician, even near the end of a career.
