Eating disorders and disordered eating are prevalent in adolescent and young adults, and affect a large proportion of young people with Type 1 diabetes. The aetiology of the disorder, screening for and diagnosis of the disorder, management, and consequences of the eating disorder are uniquely influenced by their diabetes. We present a series of cases that illustrate the range of ways eating disorders have occured in this cohort at the Queensland Diabetes and Endocrine Centre, Mater Young Adult Health Centre Brisbane, and the challenges in their management. As a consequence, we have developed a psychosocial screening tool to identify disturbed eating behaviours at an early stage, along with referral pathways and a person centred stepped care model to manage disordered eating before behaviours become entrenched. Additionally for those with an established clinical eating disorder, the diabetes multidisciplinary team work closely with an Eating Disorder Outreach Service to find the best treatment options for the adolescents and young adults.