Diabetes (Type 1)

Symptoms

The most common symptoms of type 1 diabetes are:

• peeing more than usual
• feeling very thirsty
• feeling very tired

• losing weight quickly without trying to

Other symptoms can include:

• blurred vision
• breath that smells sweet or fruity (like nail polish remover or pear drop sweets)

• cuts and wounds taking longer to heal
• getting frequent infections, such as thrush

The symptoms develop quickly, over a few days or weeks. If it's not treated, it can lead to a serious condition called diabetic ketoacidosis.

Type 1 diabetes usually starts in children and young adults, but it can happen at any age.

You're more likely to get it if you have other problems with your immune system (autoimmune conditions), or if others in your family have type 1 diabetes or other autoimmune conditions.

The symptoms are similar to type 2 diabetes, but type 2 diabetes usually develops more slowly and is more common in older people.

Diagnosis

If a GP thinks you could have type 1 diabetes, they'll do some blood tests by taking a blood sample or pricking your finger to check for high blood glucose. They may also test a sample of your pee.

If tests show you might have type 1 diabetes, you'll need to be referred to a specialist in hospital for more tests and to start treatment.

Doctors will usually confirm whether you have type 1 diabetes or another type of diabetes based on your age, weight and symptoms. But if it's not clear which type you have, you may need extra blood tests.

If you're told you have type 1 diabetes

If you or your child are diagnosed with type 1 diabetes, it can feel overwhelming. You may be feeling anxious about how it will affect you.

A team of specialists will help you get the right treatment and support. You can ask them any questions you may have.

A diabetes nurse in hospital or at a clinic will show you the things you need to do to start managing the condition.

Treatment Options

Main treatments for type 1 diabetes

When you're first diagnosed with type 1 diabetes you'll be treated in hospital by a specialist diabetes team. They'll show you how to treat your condition once you leave hospital.

The main treatment for type 1 diabetes is taking a medicine called insulin to manage your blood glucose (sugar) levels.

To stay well, you'll need to try to keep your blood glucose levels within a target range. You'll be taught how to do this by checking your blood glucose regularly and adjusting your insulin doses.

Your diabetes care team will work with you to develop a care plan.

This should include:

• advice and courses to help you learn about type 1 diabetes, including how to match your insulin dose to what you eat and drink (counting carbohydrates, or carb counting)
• what type of insulin is best for you, and how and when to take it
• how and when to check your blood glucose and what your targets are
• reviews 2 to 4 times a year of your HbA1c level, which is your average blood glucose level for the last 2 to 3 months
• how to recognise and treat low blood glucose (hypoglycaemia, or hypos) and high blood glucose (hyperglycaemia)
• advice about things like diet, alcohol, driving, exercise and what to do when you're ill (called sick day rules)
• checking for and treating any complications
• support for your wellbeing and mental health

You'll be given the equipment you need to treat your diabetes, such as a blood glucose meter and equipment for taking insulin. You'll have regular tests and check-ups with your diabetes team.

Insulin

Insulin is a medicine that reduces your blood glucose (sugar).

There are different types of insulin, taken at different times. You'll need to calculate how much you need and inject it several times a day using an insulin pen, or use an insulin pump.

Too much insulin causes hypoglycaemia, or hypos. You'll be taught how to recognise the symptoms and how to treat a hypo.

Insulin pumps

An insulin pump is a small device you attach to your skin and wear all the time. It gives you tiny amounts of insulin throughout the day and night.

This can reduce hypos and improve your blood glucose levels, compareid to insulin injections.

Types Of Insulin for Type 1 Diabetes

Most people with type 1 diabetes take both:

• a long-acting insulin (also called background or basal insulin) once or twice a day
• a rapid-acting insulin (also called mealtime or bolus insulin) before meals

This combination is sometimes known as a basal bolus regimen.

Most people with type 1 Diabetes need to calculate their rapid-acting insulin dose for each meal, depending on the amount of carbohydrates they eat (carb counting). 

If you use an insulin pump, you'll only need rapid-acting insulin. Your pump will give you small doses throughout the day so you do not need to take a long-acting insulin.

Your diabetes care team should discuss your insulin treatment with you and recommend the treatment they think is best for you. The type of insulin you take and your dose may change over time.​

Living with

Managing your blood glucose

If you have type 1 diabetes, you'll need to:

• check your blood glucose (sugar) regularly
• check how much carbohydrate is in your food and drink (called carb counting)
• take insulin several times a day
• watch out for signs of hypoglycaemia (hypos) and know how to treat it

Checking your blood glucose

Checking your blood glucose is quick and easy for most people.

You'll need a blood glucose meter, small needles (lancets) and test strips to do finger-prick tests.

You may be given a continuous glucose monitor (CGM). This gives you readings at any time and reduces the number of finger-prick tests you need to do.

It's recommended that you check your blood glucose at least 4 times a day (or at least 5 times for children), including before meals and before bed.

Check it more often when you're doing things that can affect it, such as exercise or drinking alcohol, or when you're unwell.

Carb counting

Knowing how many carbohydrates (carbs) you're eating and drinking helps you manage your blood glucose levels by matching your insulin dose to your food. This means you can be more flexible in what you eat.

Taking insulin

You'll take insulin using an insulin pen or an insulin pump. It does not usually hurt, as the needles are very small.

You'll need to adjust your dose depending on your food and drink, your blood glucose and things like how much exercise you do.

Your diabetes nurse should show you how to use your pen or pump. It's important to change where you inject or put your pump each time, and use the right technique, to help prevent problems.

Recognising and treating hypoglycaemia (hypos)

Hypoglycaemia (a hypo) happens when your blood glucose level is too low. It usually needs to be treated if it's below 4mmol/L.

Mild hypos are common and do not usually cause any lasting problems.

They can happen when you have not had enough carbohydrates or you've taken too much insulin.

You'll need to be aware of the symptoms, such as feeling hungry or dizzy, sweating and shaking.

It's important to treat a hypo quickly, before it gets worse, by having a sugary drink or snack.

Things you can do to help manage type 1 diabetes

If you have type 1 diabetes, there are things you can do to help manage your blood glucose levels and avoid any problems.

• always carry something with you that will raise your blood glucose quickly, such as sugary drinks, sweets or glucose tablets

• make sure your family and friends know how to recognise a hypo and what to do
• carry medical ID, such as a bracelet or a card that lets people know you have type 1 diabetes
• be aware of when you may need to check your blood glucose more often, such as in hot weather or during your period
• check your blood glucose before, during and after exercise – you may also need to eat more carbohydrate and reduce your insulin dose to prevent hypos
• ask your care team about getting a continuous glucose monitor if you do not already have one
• follow guidelines from your care team about what to do when you're ill and how to adjust your insulin dose (sick day rules)
• if you need to go to hospital, or have any surgery or procedures, tell the staff treating you that you have type 1 diabetes and you take insulin
• if you're going abroad, take a letter about your diabetes from your GP or diabetes team, and follow advice about travelling with insulin
• contact your diabetes team if you have any questions or concerns
• do not drink too much alcohol – keep to the recommended guidelines of no more than 14 units of alcohol a week, spread over 3 days or more
• do not drink alcohol on an empty stomach

Complications

Long-term complications of type 1 diabetes

Having type 1 diabetes can increase your chance of getting other health problems. These can develop over time and are linked to high blood glucose (sugar).

You can lower your chances of complications by managing your blood glucose as well as you can and making healthy lifestyle changes, such as eating a balanced diet, exercising and not smoking.

Your diabetes team will work with you to keep you as well as possible.

Heart disease and stroke

Type 1 diabetes can damage your blood vessels, which can lead to coronary heart disease and stroke.

As well as managing your blood glucose, you can reduce the risk by looking after your cholesterol level and blood pressure.

Adults should have tests every year to check for high cholesterol, and both adults and children will have tests for high blood pressure.

Foot problems

Diabetes can damage your nerves (called neuropathy) and reduce the blood supply to your feet, causing a loss of feeling. This means injuries do not heal well and you may not notice if you've hurt your foot.

This can lead to problems such as ulcers and infections. If these get worse, you could need surgery.

You can help to avoid problems by:

• checking your feet every day
• keeping your feet clean and dry
• wearing shoes that fit well
• having a foot check-up at least once a year

• getting medical help quickly if you injure your feet

Sight problems

Diabetes can damage the blood vessels in your eyes. This can cause sight problems (diabetic retinopathy) and in severe cases can lead to blindness, although this is uncommon.

People with type 1 diabetes are also more likely to get cataracts and glaucoma.

Adults and children aged 12 or over will be offered diabetic eye screening every year.

Changes to your eyes usually have no symptoms at first, so it's important to have this check to help find and treat any damage before it affects your sight.

Nerve damage

Diabetes can cause damage to nerves, called diabetic neuropathy.

This can lead to problems such as:

• numbness
• pain or tingling
• problems with sex
• constipation or diarrhoea

Speak to your GP or diabetes team if you get any of these symptoms.

There's no cure for nerve damage, but treatments can help with the symptoms and help stop it getting worse.

Kidney problems

Over time, high blood glucose can damage your kidneys, leading to kidney disease.

Kidney disease usually has no symptoms at first, so it's important to have a test every year to check for kidney problems.

There are treatments that can help with symptoms and may help stop it getting worse.

Gum disease

High blood glucose can increase your chance of gum disease and infections.

It's important to keep your mouth healthy by brushing your teeth twice a day and having regular dental check-ups.

See a dentist as soon as possible if you notice problems in your mouth, including soreness, bleeding gums or bad breath.