Living with type 1 diabetes
If you have type 1 diabetes, you'll need to look after your health very carefully.
Caring for your health will make treating your diabetes easier and minimise your risk of developing complications.
Type 1 diabetes is a long-term condition, which means you'll be in regular contact with your diabetes care team. Developing a good relationship with the team will enable you to freely discuss your symptoms or any concerns that you have.
The more they know, the more they can help you. Your GP or diabetes care team will also need to check your eyes, feet and nerves regularly, because they can also be affected by diabetes.
You should be tested each year to see how well your diabetes is being controlled over the long term.
A blood sample will be taken from your arm and a test known as the HbA1c test carried out. It measures how much glucose is in your red blood cells, and gives your blood glucose levels for the previous two to three months.
The HbA1c target for most people with diabetes is below 48 mmol/mol. There's evidence to show that this level can reduce the risk of complications, such as nerve damage, eye disease, kidney disease and heart disease.
An HbA1c of less than 58 mmol/mol is recommended for those at risk of severe hypoglycaemia (an abnormally low level of blood glucose).
The Diabetes UK website has more information about the HbA1c test.
It's not true that if you have diabetes you'll need to stick to a special diet. You should eat a healthy diet that's high in fibre and fruit and vegetables, and low in fat, salt and sugar.
Read more about healthy eating.
Different foods will affect you in different ways, so it's important to know what to eat and when to get the right amount of glucose for the insulin you're taking. A diabetes dietitian can help you work out a dietary plan that can be adapted to your specific needs.
It's fine for people with diabetes to eat carbohydrates. Your dietitian will explain "carb counting" to you – matching your insulin requirement with the volume of carbohydrates that you eat or drink.
The Diabetes UK website has more information about healthy eating and carb counting and insulin adjustment.
As physical activity lowers your blood glucose level, it's very important to exercise regularly if you have diabetes.
Like anyone else, you should aim to do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week. However, speak to your GP or diabetes care team before starting a new activity.
As exercise will affect your blood glucose level, you and your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.
If you have diabetes, your risk of developing a cardiovascular disease, such as a heart attack or stroke, is increased.
As well as increasing this risk further, smoking also increases your risk of developing many other serious smoking-related conditions, such as lung cancer.
If you want to give up smoking, your GP can provide you with advice, support and treatment to help you quit.
Read more about stopping smoking.
If you have diabetes, drink alcohol in moderation (if you drink), and never drink alcohol on an empty stomach. Depending on the amount you drink, alcohol can cause either high or low blood glucose levels (hyperglycaemia or hypoglycaemia).
Drinking alcohol may also affect your ability to carry out insulin treatment or blood glucose monitoring, so always be careful not to drink too much. The recommended daily alcohol limit is three to four units for men and two to three units for women.
Read more about alcohol units.
People with a long-term condition, such as type 1 diabetes, are encouraged to get a flu jab each autumn to protect against flu (influenza). A pneumoccocal vaccination, which protects against a serious chest infection called pneumococcal pneumonia, is also recommended.
Read more about self care.
Look after your feet hide
Having diabetes means that you're more likely to develop problems with your feet, including foot ulcers and infections from minor cuts and grazes. This is because blood glucose can damage the nerves in your feet.
To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly and see a podiatrist or chiropodist (a foot care specialist) regularly so that any problems are detected early.
Regularly check your feet for cuts, blisters or grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesn't start to heal within a few days.
The Diabetes UK website has more information and advice about taking care of your feet.
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Regular eye tests show
If you have type 1 diabetes, you should be invited to have your your eyes screened at once a year to check for diabetic retinopathy.
Retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long time (hyperglycaemia). If it isn't treated, retinopathy can eventually cause sight loss.
Read more about diabetic eye screening.
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If you have diabetes and you're thinking about having a baby, it's a good idea to discuss this with your diabetes care team.
A planned pregnancy enables you to make sure your blood sugar levels are as well controlled as possible before you get pregnant.
You'll need to keep your blood sugar under tight control, particularly before becoming pregnant and during the first eight weeks of pregnancy, to reduce the risk of the baby developing serious birth defects.
You should also take a higher dose of folic acid tablets. Folic acid helps prevent your baby developing spinal cord problems. Doctors now recommend that all women planning to have a baby take folic acid. Women with diabetes are advised to take 5mg a day until they're 12 weeks pregnant (only available on prescription).
You should also have your eyes checked. Retinopathy (see above) affects the blood vessels in the eyes and is a risk for all people with diabetes. Pregnancy can place extra pressure on the small vessels in your eyes, so it's important to treat retinopathy before you become pregnant.
Your GP or diabetes care team can give you further advice. Diabetes UK also provides more useful information about pregnancy and diabetes to help you get your pregnancy off to a healthy start.
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You'll be best equipped to manage your diabetes if you're given information and education when you're diagnosed, and then on an ongoing basis.
The National Institute for Health and Care Excellence (NICE) strongly recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves.
This gives people the best chance of developing the skills they need to effectively treat their condition, maintain their glucose levels at a normal level and help prevent long-term complications. It also reduces the risk of developing hypoglycaemia (low blood glucose levels).
Structured patient education
Structured patient education means there's a planned course that:
- covers all aspects of diabetes
- is flexible in content
- is relevant to a person’s clinical and psychological needs
- is adaptable to a person’s educational and cultural background
For type 1 diabetes, there's a national patient education programme called Dose Adjustment For Normal Eating (DAFNE).
DAFNE is a skills-based course where people with type 1 diabetes learn how to adjust their insulin dose to suit what they eat, rather than having to eat to match their insulin doses.
There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide.
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Diabetes and your child show
For a parent whose child is diagnosed with a life-long condition, the job of parenting becomes even tougher.
Although being diagnosed with type 1 diabetes will involve coming to terms with the diagnosis, getting used to treatment and making changes to everyday life, your child can still lead a normal and healthy life.
Below is some useful advice from Diabetes UK for parents of children with diabetes:
- Get the knowledge – make sure you understand what diabetes is, what blood glucose targets are and what your child should aim for, and how insulin or insulin pumps work. Don’t be afraid to ask your care team questions. No question is a silly question, and it’s more than likely they’ve heard it before. Ask your care team for relevant leaflets about diabetes that you can take away.
- Get the skills: make sure you're confident about the practical aspects of your child’s care. Know how to inject or manage a pump, monitor blood glucose, treat hypos, provide a healthy, balanced diet and know how illnesses, such as colds or childhood fever, can affect your child’s blood glucose levels.
- Know what care to expect: your child has the right to be treated by a specialist paediatric diabetes team, not just in a general paediatric clinic. You should also have access to a paediatric diabetes specialist nurse (PDSN). Ask for the contact numbers of your care team in case of an emergency.
- Get emotional support and start talking: feelings of depression, guilt or anger are normal, so talk to your healthcare team or ask to see a psychologist for you or your child. Ask to meet another family or go on a Diabetes UK family support weekend. Meeting other families and knowing that you’re not alone always helps.
- Work with your child’s school and teachers: agree on a healthcare plan for your child with the school and your PDSN. This should cover who gives injections and monitors blood glucose and when and whether a private area is available if your child isn't comfortable injecting in front of their classmates. Other things to consider include sharps disposal, sweet snacks in case of hypos, PE and other sporting activities. School is a big part of a child’s life so take the time to ensure your child's head teacher, teachers and classmates are educated and involved.
- Make sure life goes on: allow yourself and your child to experience normal daily routines. If your child used to spend afternoons or sleepovers at friends’ houses, ensure that this still happens. You can't be with your child 24 hours a day, so share responsibility and allow your family and friends to help. If you have other children, make sure they get your attention too. Don’t rule out sweets completely. Diabetes means low sugar, not no sugar.
The Diabetes UK website has more information and advice about your child and diabetes.
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Financial support and benefits show
If your diabetes is controlled by medication, you're entitled to free prescriptions and eye examinations.
Some people with diabetes may be eligible to receive disability benefits and incapacity benefits, depending on the impact the condition has on their life.
The main groups likely to qualify for welfare benefits are children, elderly people, people with learning disabilities or mental health problems, and those with complications of diabetes.
People over 65 who are severely disabled, may qualify for a type of disability benefit called Attendance Allowance.
Carers may also be entitled to some benefit too, depending on their involvement in caring for the person with diabetes.
Staff at your local Citizen’s Advice Bureau (CAB) can check whether you're getting all of the benefits you're entitled to. Both they and your diabetes specialist nurse should also be able to give you advice about filling in the forms.
GOV.UK has more information about benefits, and the Diabetes UK website has further advice about the Disability Living Allowance (DLA).
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Parents describe how they deal with having a diabetic child, including daily routines such as insulin injections, and how children can live life to the full.
Media last reviewed: 20/08/2013
Next review due: 20/08/2015
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Page last reviewed: 12/08/2014
Next review due: 12/08/2016