Type 1 diabetes

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. It is also known as diabetes mellitus.

Information written and reviewed by Certified Doctors.

Contents

Key Information

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What should I do?

If you think you have this condition you should see a doctor within 24 hours.

How is it diagnosed?

Your doctor might suspect type 1 diabetes mellitus based on your symptoms and physical examination findings. A blood test can be used to confirm the diagnosis, and to give an estimation on how well controlled your diabetes has been in the past three months.

What is the treatment?

Type 1 diabetes is usually treated with insulin replacement, which can be in short-acting and long-acting forms. You will need to inject insulin, and self monitor your blood sugar levels, regularly.

When to worry?

If you develop any of the following symptoms, please seek medical help immediately:

  • loss of consciousness
  • drowsiness
  • confusion
  • abdominal pain
  • passing more urine than usual
  • fast breathing or shortness of breath
  • vomiting.

Introduction

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Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. It is also known as diabetes mellitus.

Types of diabetes

There are two main types of diabetes: type 1 and type 2.

Type 1 diabetes is often referred to as insulin-dependent diabetes. It is also sometimes known as juvenile diabetes or early-onset diabetes because it often develops before the age of 40, usually during the teenage years.

In type 1 diabetes, the pancreas (a small gland behind the stomach) does not produce any insulin. Insulin is a hormone that regulates blood glucose levels. If the amount of glucose in the blood is too high, it can seriously damage the body's organs.

If you have type 1 diabetes, you will need to take insulin injections for life. You must also make sure that your blood glucose levels stay balanced by eating a healthy diet, taking regular exercise and having regular blood tests.

In type 2 diabetes, the body does not produce enough insulin, or the body's cells do not react to it. This is known as insulin resistance.

This topic focuses on type 1 diabetes. Read more about type 2 diabetes.

Diabetes symptoms

Diabetes can cause various symptoms, including:

  • feeling very thirsty
  • urinating frequently, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk (in type 1 diabetes)

Read more about symptoms of type 1 diabetes.

Causes of type 1 diabetes

Type 1 diabetes occurs because your body is unable to produce insulin. Insulin usually moves glucose out of your blood and into your cells, where it is converted to energy. However, in type 1 diabetes, there is no insulin to move glucose out of your bloodstream and into your cells.

Without insulin, the body breaks down its own fat and muscle (leading to weight loss). In type 1 diabetes this can lead to a serious short- term condition where the bloodstream becomes acidic along with dangerous dehydration (diabetic ketoacidosis).

Type 1 diabetes is an autoimmune condition, where your immune system (the body's natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them.

Read more information about the causes of type 1 diabetes.

Treating type 1 diabetes

It is important that diabetes is diagnosed as early as possible so that treatment can be started.

Diabetes cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible, and control your symptoms to prevent health problems developing later.

If you are diagnosed with diabetes, you will be referred to a diabetes care team for specialist treatment. Your care team will be able to explain your condition to you in detail and help you understand your treatment. They will also closely monitor your condition.

As your body cannot produce any insulin, you will need to have regular insulin treatment to keep your glucose levels normal. You will need to learn how to match the insulin you inject to the food you eat, taking into account your blood glucose level and how much exercise you do. This skill needs to be practised and learnt gradually. Many centres now provide courses to teach these skills.

Insulin comes in several different forms, each of which works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but do not last very long (rapid-acting). Your treatment may include a combination of these different insulin preparations.

Some people with type 1 diabetes may benefit from a fairly new procedure known as islet transplantation. It involves implanting healthy islet cells from the pancreas of a deceased donor into the pancreas of someone with type 1 diabetes.

Islet transplants have been shown to be an effective way of reducing the risk of severe hypoglycaemic attacks or ‘hypos’ (where a person’s blood sugar falls to an abnormally low level).

Read more information about diagnosing diabetes and treating type 1 diabetes.

Complications

Left untreated, diabetes can cause many different health problems. Large amounts of glucose can damage blood vessels, nerves and organs.

Even a mildly raised glucose level that does not cause any symptoms can have damaging effects in the long term.

Read more about the complications of type 1 diabetes.

Living with diabetes

If you have type 1 diabetes, you will need to look after your health very carefully. Caring for your health will also make treating your diabetes easier and minimise your risk of developing complications.

Eating a healthy, balanced diet and exercising regularly will lower your blood glucose level, and stopping smoking (if you smoke) will reduce your risk of developing a cardiovascular disease.

Read more about living with diabetes.

Diabetes in pregnancy

During pregnancy, some women have such high levels of glucose in their blood that their body cannot produce enough insulin to absorb it all. This is known as gestational diabetes, and it affects approximately 5% of pregnant women. For people with existing type 1 diabetes, pregnancy can also make this worse.

Gestational diabetes can increase the risk of health problems in an unborn baby, so it is important to keep the levels of glucose in your blood under control.

In most cases, gestational diabetes develops in the second half of pregnancy and disappears after the baby is born.

Read more information about [diabetes in pregnancy] and gestational diabetes.

Symptoms

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The main symptoms of diabetes that are common to type 1 and type 2 are:

  • feeling very thirsty
  • urinating frequently, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk (in type 1 diabetes)

Symptoms of type 1 diabetes can develop quickly, over weeks or even days. Other symptoms include:

  • itchiness around the vagina or penis, or regular bouts of thrush (a yeast infection)
  • blurred vision that is caused by the lens of your eye changing shape
  • cramps
  • skin infections

Vomiting or heavy, deep breathing can also occur at a later stage. This is a dangerous sign and requires immediate admission to hospital for treatment.

Hypoglycaemia (low blood glucose)

If you have diabetes, your blood glucose levels can become very low. This is known as hypoglycaemia (or a "hypo"), and happens because any insulin in your body has moved too much glucose out of your bloodstream.

In most cases, hypoglycaemia occurs as a result of taking too much insulin, although it can also develop if you skip a meal, exercise very vigorously or drink alcohol on an empty stomach.

Symptoms of a "hypo" include:

  • feeling shaky and irritable
  • sweating
  • tingling lips
  • feeling weak
  • hunger
  • nausea (feeling sick)

A hypo can be brought under control simply by eating or drinking something sugary.

If a hypo is not brought under control it can lead to confusion, slurred speech and unconsciousness. If this occurs, you will need to have an emergency injection of a hormone called glucagon. This hormone increases the glucose in your blood.

Read more about hypoglycaemia.

Hyperglycaemia (high blood glucose)

As diabetes occurs as a result of your body being unable to produce any, or enough, insulin to regulate your blood glucose, your blood glucose levels may become very high. This happens because there is no insulin to move glucose out of your bloodstream and into your cells to produce energy.

If your blood glucose levels become too high, you may experience hyperglycaemia. The symptoms of hyperglycaemia are similar to the main symptoms of diabetes, but they may come on suddenly and severely. They include:

  • extreme thirst
  • a dry mouth
  • blurred vision
  • drowsiness
  • a need to pass urine frequently

Left untreated, hyperglycaemia can lead to diabetic ketoacidosis, which is a serious condition where the body breaks down fat and muscle as an alternative source of energy. This leads to a build-up of acids in your blood, which can cause vomiting, dehydration, unconsciousness and even death.

Read more about hyperglycaemia.

When to seek urgent medical attention

You should seek urgent medical attention if you have diabetes and you develop:

  • a loss of appetite
  • nausea or vomiting (feeling or being sick)
  • a high temperature
  • stomach pain
  • fruity smelling breath, which may smell like pear drops or nail varnish (others will usually be able to smell it but you will not)

Causes

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Type 1 diabetes occurs when the body is unable to produce insulin. Insulin is a hormone that is needed to control the amount of glucose (sugar) in your blood.

When you eat, your digestive system breaks down food and passes its nutrients into your bloodstream.

The pancreas (a small gland behind your stomach) usually produces insulin, which transfers any glucose out of your blood and into your cells, where it is converted to energy.

However, if you have type 1 diabetes, your pancreas is unable to produce any insulin. This means that glucose cannot be moved out of your bloodstream and into your cells.

Autoimmune condition

Type 1 diabetes is an autoimmune condition. Your immune system (the body's natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them, destroying them completely or damaging them enough to stop them producing insulin.

It is not known exactly what triggers the immune system to do this, but some researchers have suggested that it may be due to a viral infection.

Type 1 diabetes is usually inherited (runs in families), so the autoimmune reaction may also be genetic.

If you have a close relative, such as a parent, brother or sister with type 1 diabetes, you have about a 6% chance of also developing the condition. The risk for people who do not have a close relative with type 1 diabetes is just under 0.5%.

Diagnosis

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It is important to diagnose diabetes as early as possible so that treatment can be started.

If you experience the symptoms of diabetes, you should visit your doctor as soon as possible. They will ask you about your symptoms and may request a urine and blood test.

Urine and blood tests

Your urine sample will be tested to see whether it contains glucose. Urine does not usually contain glucose, but if you have diabetes, some glucose can overflow through the kidneys and into the urine. Your urine may also be tested for ketones (chemicals) which indicate type 1 diabetes.

If your urine contains glucose, a blood test can be used to confirm the diagnosis of diabetes. A sample of your blood will be taken in the morning, before you have had anything to eat, and it will be tested to measure your blood glucose levels.

If your blood glucose levels are not high enough for your doctor to diagnose diabetes, you may need to have an oral glucose tolerance test (OGTT). This is also sometimes referred to as a glucose tolerance test (GTT).

After drinking a glucose drink, samples of your blood will be taken every half an hour, for two hours. The samples will be tested to find out how your body is dealing with the glucose.

Treatment

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Insulin treatment

As type 1 diabetes occurs because your body cannot produce any insulin, you will need regular insulin treatment to keep your glucose levels normal.

Insulin comes in several different preparations, each of which works slightly differently. For example, some last up to a whole day (long-acting), some last up to eight hours (short-acting) and some work quickly but do not last very long (rapid-acting). Your treatment may include a combination of these different insulin preparations.

Insulin injections

In most cases of type 1 diabetes, you will need to have insulin injections. Insulin must be injected because if it were taken as a tablet, it would be broken down in your stomach, just like food, and would be unable to enter your bloodstream.

When you are first diagnosed, your diabetes care team will help you with your insulin injections, before showing you how and when to do it yourself. They will also show you how to store your insulin and dispose of your needles properly.

Insulin injections are either given with a syringe or an injection pen, which is also known as an insulin pen or auto-injector. Most people need two-to-four injections a day. Your doctor or diabetes nurse may also teach one of your close friends or relatives how to inject the insulin properly.

Insulin pump therapy

Insulin pump therapy is an alternative to injecting insulin. An insulin pump is a small device that holds insulin and is about the size of a pack of playing cards.

The pump is attached to you by a long, thin piece of tubing, with a needle at the end, which is inserted under your skin. Most people insert the needle into their stomach, but you could also insert it into your hips, thighs, buttocks or arms.

The pump allows insulin to flow into your bloodstream at a rate that you can control. This means you no longer need to give yourself injections, although you will need to monitor your blood glucose levels very closely to ensure you are receiving the right amount of insulin.

Insulin pump therapy can be used by adults, teenagers and children (with adult supervision) who have type 1 diabetes. However, it may not be suitable for everyone. Your diabetes care team may suggest pump therapy if you often have low blood glucose (hypoglycaemia).

Monitoring blood glucose

Monitoring your blood glucose levels

An important part of your treatment is to make sure that your blood sugar level is as normal and stable as possible.

You will be able to manage this using insulin treatment and by eating a healthy diet, but you will also have to regularly check your blood glucose levels to make sure they are not too high or too low.

Exercise, illness, stress, drinking alcohol, taking other medicines and, for women, changes to your hormone levels during your monthly period can all affect your blood sugar levels.

In most cases, you will need to check your blood glucose levels at home using a simple finger prick blood test. You may need to do this up to four or more times a day, depending on the type of insulin treatment you are taking. Your diabetes care team will talk to you about your ideal blood glucose level.

The normal blood sugar level is 4.0-7.0 mmol/l before meals and less than 9.0 mmol/l two hours after meals. Mmol/l means millimoles per litre, and it is a way of defining the concentration of glucose in your blood.

Find out how to test your glucose levels.

Having your blood glucose levels checked

As well as monitoring your blood glucose levels every day, your doctor or diabetes care team will also carry out a special blood test every two-to-six months. This will show how stable your glucose levels have been over the past 6-12 weeks, and how well your treatment plan is working.

This additional blood test is known as the HbA1c test. Unlike the finger prick test that measures blood sugar at a single time, the HbA1c test gives an idea of blood glucose levels over time.

It measures the amount of haemoglobin, which is the oxygen-carrying substance in red blood cells that has glucose attached to it. A high HbA1c level may indicate that your blood glucose level is consistently high and that your diabetes treatment plan needs to be altered.

Treating hypoglycaemia (low blood glucose)

Hypoglycaemia can occur when your blood glucose level becomes very low. It is likely that you will develop hypoglycaemia from time to time.

Mild hypoglycaemia (or a 'hypo') can make you feel shaky, weak and hungry, and can be controlled by eating or drinking something sugary, such as a fizzy drink (not a diet version), sugar cubes or raisins. You may also be able to take pure glucose, in the form of a tablet or fluid, if you need to control the symptoms of a hypo quickly.

If you develop severe hypoglycaemia, you can become drowsy and confused, and you may even lose consciousness. If this occurs, you will need to have an injection of glucagon into your muscle or glucose into one of your veins. Glucagon is a hormone that quickly increases your blood glucose levels.

Your diabetes care team may show several of your family members and close friends how to inject the glucagon or glucose, should you need it.

Once you begin to come round, you will need to eat something sugary when you are alert enough to do so. If you lose consciousness as a result of hypoglycaemia, there is a risk that it could happen again within a few hours, so you will need to rest afterwards and have someone with you.

If the glucagon injection into your muscle does not work and you are still drowsy or unconscious 10 minutes after the injection, you will need urgent medical attention.

You will need to have another injection of glucagon straight into a vein, which must be given by a trained healthcare professional.

If you have type 1 diabetes, it is recommended that you carry identification with you so that people will be aware of the problem if you become hypoglycaemic.

Islet transplantation

Some people with type 1 diabetes may benefit from a fairly new procedure known as islet transplantation. It involves implanting healthy islet cells from the pancreas of a deceased donor into the pancreas of someone with type 1 diabetes.

In 2008, a government-funded islet transplant programme was introduced, and the procedure is now available through the NHS for people who satisfy certain criteria (see below).

You may be suitable for an islet transplant if you:

  • have had two or more severe hypos within the last two years and you have a poor awareness of hypoglycaemia
  • have a working kidney transplant, severe hypos and poor hypoglycaemia awareness, or poor blood glucose control even after receiving the best medical treatment

You may not be suitable for an islet transplant if you:

  • weigh over 85kg (13st 5.4lb)
  • have poor kidney function
  • need a lot of insulin - for example, over 50 units a day for a 70kg (11st) person

An islet transplant is a minor, low-risk procedure that is carried out under local anaesthetic.

The procedure has been shown to be effective at reducing the risk of severe hypos. So far, the results of islet transplants carried out in the UK have shown a significant reduction in the number of hypos, from 23 per person per year before transplantation to less than one per person per year afterwards.

Treating hyperglycaemia (high blood glucose)

Hyperglycaemia can occur when your blood glucose levels become too high. It can happen for several reasons, such as eating too much, being unwell or not taking enough insulin.

If you develop hyperglycaemia, you may need to adjust your diet or your dose of insulin to keep your glucose levels normal. Your diabetes care team will be able to advise you about the best way to do this.

If hyperglycaemia is not treated, it can lead to diabetic ketoacidosis, where the body begins to break down fats for energy instead of glucose, resulting in a build-up of acids in your blood.

This is very serious and if it is not addressed quickly it can cause unconsciousness and, eventually, death. Read more about the symptoms of diabetic ketoacidosis.

If you develop diabetic ketoacidosis, you will need urgent hospital treatment. You will be given insulin directly into a vein (intravenously). If you are dehydrated, you may also need to have other fluids given by a drip, including salt solution and potassium.

Other treatments

Type 1 diabetes can lead to long-term complications. If you have type 1 diabetes, you have an increased risk of developing heart disease, stroke and kidney disease. To reduce the chance of this, you may be advised to take:

  • anti-hypertensive medicines to control high blood pressure
  • a statin, such as simvastatin, to reduce high cholesterol levels
  • low-dose aspirin to prevent stroke
  • angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril if you have the early signs of diabetic kidney disease

Diabetic kidney disease is identified by the presence of small amounts of a protein called albumin in your urine. It is often reversible if treated early enough.

Complications

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If diabetes is not treated, it can lead to a number of different health problems. High glucose levels can damage blood vessels, nerves and organs.

Even a mildly raised glucose level that does not cause any symptoms can have damaging effects in the long term.

Heart disease and stroke

If you have diabetes, you are up to five times more likely to develop heart disease or have a stroke.

Prolonged, poorly controlled blood glucose levels increase the likelihood of developing atherosclerosis (furring and narrowing of your blood vessels).

This may result in a poor blood supply to your heart, causing angina (a dull, heavy or tight pain in the chest). It also increases the chance that a blood vessel in your heart or brain will become completely blocked, leading to a heart attack or stroke.

Nerve damage

High blood glucose levels can damage the tiny blood vessels of your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation.

Retinopathy

Retinopathy is where the retina (the light-sensitive layer of tissue) at the back of the eye is damaged. Blood vessels in the retina can become blocked or leaky, or can grow haphazardly. This prevents the light from fully passing through to your retina. If it is not treated, it can damage your vision.

The better you control your blood sugar levels, the lower your risk of developing serious eye problems. Having an annual eye check with a specialist (an ophthalmologist or an optometrist) can help pick up signs of a potentially serious eye problem early so that it can be treated.

Diabetic retinopathy can be managed using laser treatment if it is caught early enough. However, this will only preserve the sight you have but will not make it better.

Kidney disease

If the small blood vessels of your kidney become blocked and leaky, your kidneys will work less efficiently.

In rare, severe cases, this can lead to kidney failure and the need for dialysis (treatment to replicate the functions of the kidneys). In some cases, a kidney transplant may be necessary.

Foot problems

Damage to the nerves of the foot can mean that small nicks and cuts are not noticed, which can lead to the development of a foot ulcer. About 1 in 10 people with diabetes get a foot ulcer, which can cause serious infection.

If you develop nerve damage, you should check your feet every day and report any changes to your doctor, nurse or podiatrist. Look out for sores and cuts that do not heal, puffiness or swelling and skin that feels hot to the touch. You should also have a foot examination at least once a year.

Sexual dysfunction

In men with diabetes, particularly those who smoke, nerve and blood vessel damage can lead to erection problems. This can usually be treated with medication.

Women with diabetes may experience:

  • a reduced sex drive
  • reduced pleasure from sex
  • vaginal dryness
  • a reduced ability to orgasm
  • pain during sex

If you experience a lack of vaginal lubrication, or you find sex painful, you can use a vaginal lubricant or a water-based gel.

Miscarriage and stillbirth

Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If your blood sugar level is not carefully controlled during early pregnancy, there is also an increased risk of the baby developing a serious birth defect.

Pregnant women with diabetes will usually have their antenatal check-ups in hospital or a diabetic clinic. This allows doctors to keep a close eye on their blood sugar levels and control their insulin dosage more easily.

Living with type 1 diabetes

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Look after your feet

Having diabetes means that you are 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 specialist in foot care) 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 doctor if you have a minor foot injury that does not start to heal within a few days.

Regular eye tests

If you have type 1 diabetes, have your eyes tested at least once a year to check for 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 is not treated, retinopathy can eventually cause blindness.

Pregnancy

If you have diabetes and are thinking about having a baby, it is 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 will 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.

In addition to this, you should:

  • 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 each day (only available on prescription).
  • Have your eyes checked. Retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes. Pregnancy can place extra pressure on the small vessels in your eyes, so it is important to treat retinopathy before you become pregnant.

Your doctor or diabetes care team can give you further advice. Diabetes UK also provides useful information to help you get your pregnancy off to a healthy start. Read more about diabetes in pregnancy.

Get educated

You will be best equipped to manage your diabetes if you are given information and education when you are diagnosed and on an ongoing basis.

This gives people the best chance of developing the skills they need to effectively treat their diabetes, maintain their glucose levels close to normal and help prevent long-term complications. It also reduces the risk of developing hypoglycaemia.

Structured patient education

Structured patient education means that there is 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 is a national patient education programme called the DAFNE (Dose Adjustment For Normal Eating).

DAFNE is a skills-based course in which 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.

Diabetes and your child

For any parent whose child is diagnosed with a life-long, chronic condition, the tough job of parenting becomes even tougher.

Although having type 1 diabetes involves 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.

Diabetes Advisor Libby Dowling offers her advice to 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 any questions you want. 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 illness, such as colds or 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.

Talk to others

Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes.

Patient organisations have local groups where you can meet others who have been diagnosed with the condition.

Content supplied by NHS Choices