Insulin-dependent diabetes - Living with type 1 diabetes

Look after your feet

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.

Regular eye tests

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.

Pregnancy

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.

Education

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.

Diabetes and your child

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.

Help and support

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've been diagnosed with the condition.

The Diabetes UK website enables you to find your local diabetes support group. If you want to contact a trained counsellor directly, you can phone Diabetes UK’s care line on 0345 123 2399, or email careline@diabetes.org.uk.

The Juvenile Diabetes Research Foundation (JDRF) also holds regular local events.

Financial support and benefits

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).