Diabetes – Type 1

Managing type 1 diabetes can take time to get used to, but you can still do all the things you enjoy.

When you’re diagnosed with type 1 diabetes you’ll, be asked to eat meals and inject insulin at set times every day. When you’re more confident, you can try a more flexible insulin treatment plan to suit your lifestyle. This might allow you to eat when you want. Speak to your diabetes team when you feel ready.

Your treatment might also need to change as you get older or if your body changes. This includes:

• Losing or putting on weight
• Being ill
• Pregnancy
• Menopause
• Periods
• Stress

Insulin is a hormone made in your pancreas. It helps your body use glucose (sugar) for energy.

In type 1 diabetes the pancreas no longer creates insulin, so you have to inject it to regulate your blood glucose levels.

There are different types of insulin, taken at different times:

Insulin taken once or twice a day

This is called basal insulin. It gives your body the insulin it needs whether you eat or not. Basal Insulin should keep your blood glucose stable overnight and between meals.

Insulin taken with food and drink

This is called bolus insulin. It helps reduce the rise in blood glucose caused by eating or drinking. It would usually be taken before a meal, snack or drink with carbohydrates in it.

Hypoglycaemia

Hypoglycaemia (a Hypo) is when your blood glucose level is too low, usually below 4mmol/L.

This can happen if you delay meals or if you haven’t taken enough carbohydrates in your last meal. It can also happen if you take too much insulin or if you drink alcohol on an empty stomach.

Hypoglycaemia can come on very quickly so you need to be aware of the signs:

• Sweating
• Feeling anxious and irritable
• Feeling hungry
• Difficulty concentrating
• Blurred vision
• Confusion

Before it gets worse you should eat something sugary such as glucose sweets, jelly babies or drink a glass of fruit juice. Check your blood glucose after 10 minutes and if it’s still low, eat something sugary again.

Learn more about what to do if you’re having a hypo by clicking here.

Hyperglycaemia

Hyperglycaemia (a Hyper) is when your blood glucose levels are too high. This can happen if you’re

• Stressed
• Unwell
• Less active
• Not had enough insulin for the carbohydrate you’ve eaten.

It is important to be aware of the signs. Speak to your care team if you:

• Feel dehydrated
• Urinate more than usual
• Feel fatigued all the time.
• Have unintended weight loss
• Blurred vision
• Your breath smells of ketones (alcohol)

Very high blood sugar levels can lead to a serious problem called diabetic ketoacidosis. This is when the body starts to breakdown fat for energy when there’s not enough insulin. This leads to a build-up of acid in your blood. This would be treated in hospital.

Learn more what to do if you’re having a hyper by clicking here

Having type 1 diabetes does not mean you are more likely to get ill more frequently than usual.

If you do get ill, it can make your blood glucose higher, so you’ll have to take extra care – Particularly if you’re being sick or not eating much.

You should:

• Keep taking your insulin
• Test glucose more often than normal
• Drink lots of water or sugar free drinks to avoid dehydration
• Check for ketones – you can get strips from your care team to test your urine
• Try to eat – if you can’t, drink sugary or milky drinks, try ice cream or suck on sweets.
• Don’t worry about taking sugary medicine – small amounts won’t matter.

You will need to let the DVLA know you have diabetes.

If you have diabetes and drive you will need to check the following:

• Blood glucose 2 hours before driving
• Check your blood every 2 hours if you’re on a long journey
• Travel with sugary snacks and snacks with long last carbs i.e. cereal bar or banana.

If you feel your levels are low you should stop the car as soon as it’s safe. Check your blood glucose and treat your hypoglycaemia. Do not drive for 45 minutes after you start to feel better.

Diabetes courses are encouraged for everyone with type 1 diabetes. It doesn’t matter how long you have had it.

There are different ways to do it and the courses are free.

Face-to-face course

You learn in a small group and meet people going through the same thing – this can give you support during and after the course. Courses usually run for 4 days.

What you’ll learn:

• Carb counting and insulin adjustment
• Exercise
• Hypoglycaemia
• Complications
• What to do if you’re ill.

Online Courses

Learning online means you can take the course at your own pace and at a time that suits you. You can leave and come back anytime.

This might be useful if you have just been diagnosed as there is a lot to take in, or if you have already done a course but need a refresher. Online courses are designed for everyone with any level of computer skills. You can do it on your phone, tablet or laptop.

Online Courses:

Click on the links below to access online courses:

• Diabetes UK
• BERTIE

Diabetes can damage your nerves. Let your GP or diabetes nurse know if you notice any changes. Early treatment can prevent nerve damage getting worse.

Feet

Diabetes can reduce the blood supply to your feet and cause a loss of feeling. Foot injuries don’t heal as well; this can lead to ulcers and infections.

Check your feet every day and speak to your GP or diabetes nurse if you notice any changes.

Please see the link below for more information on how to check your feet:

• Diabetes UK – foot care

Annual eye check-up

Your eyes should be checked every year; it’s called diabetic eye screening. This is to check the blood vessels in your eye have not been damaged.

Speak to your GP straight away if you are experiencing blurred vision, shapes floating in your vision or have sudden sensitivity to light and they will direct you to the most appropriate service to have further checks.

Annual heart check-up

You should have your blood cholesterol and blood pressure checked at least once a year if you have diabetes. If you smoke, you should stop. Diabetes makes the damaging effects of smoking on your heart and blood vessels (to your feet, eyes etc.) much worse.

Annual flu vaccine

Get vaccinated for flu every year. Everyone with type 1 diabetes can get it for free. Check with your GP surgery when they offer the flu vaccine. It will usually be around October & November time.