Diabetes, type 1

Overview

Diabetes, type 1
Diabetes, type 1

Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high.

The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood.

There are two main types of diabetes:
  • Type 1 – where the pancreas doesn't produce any insulin
  • Type 2 – where the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin

This topic is about type 1 diabetes. Other types of diabetes are covered separately (read about  type 2 diabetes. and gestational diabetes, which affects some women during pregnancy).

Diabetes symptoms

Typical symptoms of type 1 diabetes are :
  • feeling very thirsty
  • passing urine more often than usual, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk

The symptoms of type 1 diabetes usually develop very quickly in young people (over a few days or weeks). In adults, the symptoms often take longer to develop (a few months).

Read more about the symptoms of type 1 diabetes.

These symptoms occur because the lack of insulin means that glucose stays in the blood and isn’t used as fuel for energy. Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine.

It's very important for diabetes to be diagnosed as soon as possible, because it will get progressively worse if left untreated.

Read about how type 1 diabetes is diagnosed.

Causes of type 1 diabetes 

Type 1 diabetes is an autoimmune condition, which means your immune system attacks healthy body tissue by mistake. In this case, it attacks the cells in your pancreas.

Your damaged pancreas is then unable to produce insulin. So, glucose cannot be moved out of your bloodstream and into your cells.

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

It's not known exactly what triggers the immune system to attack the pancreas, but some researchers have suggested it may be a viral infection.

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 don't have a close relative with type 1 diabetes is just under 0.5%.

Treating type 1 diabetes

Diabetes can't 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 in life.

If you're diagnosed with diabetes, you'll be referred to a diabetes care team for specialist treatment and monitoring.

As your body can't produce insulin, you'll need regular insulin injections to keep your glucose levels normal. 

There are alternatives to insulin injections, but they're only suitable for a small number of patients.

Read more about treating type 1 diabetes.

Complications

Diabetes can cause serious long-term health problems. It's the most common cause of vision loss and blindness in people of working age.

Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year for diabetic retinopathy.

The diabetic screening only checks for changes due to diabetes, having diabetes means you may be more likely to get other eye conditions like glaucoma or cataracts so it is also important that you have a regular eye examination (which will be free on the NHS) with your local optometrist/Optician.

Find an optometrist/optician here

Diabetes is the reason for many cases of kidney failure and lower limb amputation.

People with diabetes are up to five times more likely to have cardiovascular disease, such as a stroke, than those without diabetes.

Read more about the complications of type 1 diabetes.

Living with diabetes

If you have type 1 diabetes, you'll need to look after your health very carefully. This means:

Read more about living with diabetes.

Symptoms

The symptoms of type 1 diabetes can develop very quickly (over a few days or weeks), particularly in children.

In older adults, the symptoms can often take longer to develop (a few months).

However, they should disappear when you start taking insulin and you get the condition under control.

The main symptoms of diabetes are:

  • feeling very thirsty
  • urinating more frequently than usual, particularly at night
  • feeling very tired
  • weight loss and loss of muscle bulk
  • itchiness around the genital area, or regular bouts of thrush (a yeast infection)
  • blurred vision caused by the lens of your eye changing shape
  • slow healing of cuts and grazes

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.

You should visit your GP immediately if you think you may have diabetes.

When to seek urgent medical attention

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

  • a loss of appetite
  • nausea or vomiting
  • 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 won't)

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 it's triggered when injected insulin in your body moves 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
  • feeling confused
  • hunger
  • nausea (feeling sick)

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

If it isn't brought under control, a hypo can cause confusion, slurred speech and, eventually, unconsciousness.

In this case, an emergency injection of a hormone called glucagon will be needed. Glucagon increases the glucose in your blood.

Hyperglycaemia (high blood glucose)

As people with type 1 diabetes cannot produce any insulin, their blood glucose levels may become very high.

When your blood glucose levels become too high, it is known as hyperglycaemia. The symptoms of hyperglycaemia may come on suddenly and include:

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

Left untreated, hyperglycaemia can lead to diabetic ketoacidosis. This 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.

The Diabetes UK website has more information about diabetes symptoms.

Diagnosis

It's important to diagnose diabetes as early as possible, so that treatment can be started.

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

Your urine sample will be tested to see whether it contains glucose. Urine doesn't usually contain glucose, but may pass from the kidneys into your urine if you have diabetes.

If your urine contains glucose, a specialised blood test known as glycated haemoglobin (HbA1c) can be used to determine whether you have diabetes.

Glycated haemoglobin (HbA1c) test

The glycated haemoglobin (HbA1c) test can be used to diagnose diabetes.

It can also be used to show how well their diabetes is being controlled.

The HbA1c test gives your average blood glucose level over the previous two to three months. The results can indicate whether the measures you're taking to control your diabetes are working, by meeting agreed personal targets.

If you've been diagnosed with diabetes, it's recommended that you have your HbA1c measured at least twice a year. However, you may need to have your HbA1c measured more frequently if:
  • you've recently been diagnosed with diabetes
  • your blood glucose remains too high
  • your treatment plan has been changed

The HbA1c test can be carried out at any time of day and doesn't require any special preparation, such as fasting. However, it's less reliable in certain situations, such as during pregnancy.

The advantages associated with the HbA1c test make it the preferred method of assessing how well blood glucose levels are being controlled in a person with diabetes.

HbA1c is also increasingly being used as a diagnostic test for type 2 diabetes, and as a screening test for people at high risk of diabetes.

Type 1 diabetes in children

The majority of children who develop diabetes will have type 1 diabetes.

You'll need to manage your child's condition as part of your daily life, but you'll be introduced to a specialist diabetes care team who can help you to come to terms with any challenges.

Treatment

There's no cure for diabetes, so treatment aims to keep your blood glucose levels as normal as possible and to control your symptoms to prevent health problems developing later in life.

If you've been diagnosed with diabetes, you'll be referred for specialist treatment from a diabetes care team. They'll be able to help you understand your treatment and closely monitor your condition to identify any health problems that may occur.

Type 1 diabetes occurs because your body doesn't produce any insulin. This means you'll 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 don't last very long (rapid-acting). Your treatment is likely to include a combination of these different insulin preparations.

Insulin injections

If you have type 1 diabetes, you'll probably need insulin injections. Insulin must be injected, because if it were taken as a tablet, it would be broken down in your stomach – like food – and would be unable to enter your bloodstream.

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

Insulin injections are usually given by an injection pen, which is also known as an insulin pen or auto-injector. Sometimes, injections are given using a syringe. Most people need two to four injections a day.

Your GP 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 continuously flow into your bloodstream at a rate you can control. This means you no longer need to give yourself injections, although you'll need to monitor your blood glucose levels very closely to ensure you're 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 have frequent episodes of low blood glucose (hypoglycaemia).

Monitoring blood glucose

If you have type 1 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months.

This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working.

The HbA1c test is used to measure blood glucose levels over the previous two to three months.

HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it.

A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed.

Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 59mmol/mol (7.5%). However, it can be as low as 48mmol/mol (6.5%) for some people.

Monitoring your own blood glucose

If you have type 1 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home.

Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels.

Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle.

A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful for detecting high blood sugar (hyperglycaemia) or low blood sugar (hypoglycaemia).

If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low.

Blood glucose meters aren't currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if you're unsure.

Diabetes UK also provides further information about the availability of blood glucose test strips (PDF, 195kb).

Regularly monitoring your blood glucose levels will ensure your blood glucose is as normal and stable as possible.

As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment you're taking.

In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood.

A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short.

A normal blood glucose level is 4-6 mmol/l before meals (preprandial) and less than 10 mmol/l two hours after meals (postprandial), although this can vary from person to person.

Your diabetes care team can discuss your blood glucose level with you in more detail.

Treating hypoglycaemia (low blood glucose)

If you have type 1 diabetes that's controlled using insulin or certain types of tablets, you may experience episodes of hypoglycaemia.

Hypoglycaemia is where your blood glucose levels become very low.

Mild hypoglycaemia (or a "hypo") can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary

If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets.

This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit.

In most cases, these measures will be enough to raise your blood glucose level to normal, although it may take a few hours.

If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness.

If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels.

Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one.

Treating hyperglycaemia

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 insulin dose to keep your glucose levels normal. Your diabetes care team can advise you about the best way to do this.

If hyperglycaemia isn't treated, it can lead to a condition called diabetic ketoacidosis, where the body begins to break down fats for energy instead of glucose, resulting in a build-up of ketones (acids) in your blood.

Diabetic ketoacidosis is very serious and, if not addressed quickly, it can lead to unconsciousness and, eventually, death.

The signs of diabetic ketoacidosis include:

  • frequently passing urine
  • thirst
  • tiredness and lethargy (lack of energy)
  • blurry vision
  • abdominal (stomach) pain
  • nausea and vomiting
  • deep breathing
  • smell of ketones on breath (described as smelling like pear drops)
  • collapse and unconsciousness

Your healthcare team will educate you on how to decrease your risk of ketoacidosis by testing your own blood for ketones using blood ketone sticks if you're unwell.

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

The Diabetes UK website has more information about diabetic ketoacidosis.

Other treatments

Type 1 diabetes can lead to long-term complications. If you have the condition, 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's often reversible if treated early enough.

Care standards for diabetes

The aim of treating diabetes is to help people with the condition control their blood glucose levels and minimise the risk of developing future complications.

There is also a National Service Framework for Diabetes in Wales. The progressive implementation of which will lead to the improvement of the quality of care and treatment for those living with diabetes.

Complications

If diabetes isn't 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 doesn't cause any symptoms can have damaging effects in the long term.

Heart disease and stroke

If you have diabetes, you're up to five times more likely to develop coronary 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. It can also cause numbness, which can lead to ulceration of the feet.

Damage to the peripheral nervous system (the nervous system outside the brain and spinal cord) is known as peripheral neuropathy.

If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation.

Diabetic Retinopathy

Diabetic Retinopathy is where the retina (the light-sensitive layer of tissue) at the back of the eye is damaged.

The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels and affect your vision.

Annual eye checks are usually organised by a regional photographic unit. If significant damage is detected, you may be referred to a doctor who specialises in treating eye conditions (ophthalmologist).

The better you control your blood sugar levels, the lower your risk of developing serious eye problems.

Diabetic retinopathy can be managed using laser treatment if it is caught early enough. However, this will only preserve the sight you have, rather than improve it.

Kidney disease

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

It's usually associated with high blood pressure, and treating this is a key part of management.

In rare, severe cases, this can lead to kidney failure  This can mean treatment with dialysis, or sometimes a kidney transplant becomes necessary.

Foot problems

Damage to the nerves of the foot can mean that small nicks and cuts aren't noticed and this, in combination with poor circulation,can lead to a foot ulcer. About 1 in 10 people with diabetes get a foot ulcer, which can cause serious infection.

If you have diabetes, look out for sores and cuts that don't heal, puffiness or swelling, and skin that feels hot to the touch. You should also have a foot examination at least once a year.

If poor circulation or nerve damage is detected, check your feet every day and report any changes to your doctor, nurse or podiatrist.

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 (loss of libido)
  • 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 isn't carefully controlled immediately before and during early pregnancy, there's 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 diabetes clinic, ideally with a doctor who specialises in pregnancy care (an obstetrician).

This will allow your care team to keep a close eye on your blood glucose levels and control your insulin dosage more easily, as well as monitoring the growth and development of your baby.

Looking after your eyes

The Diabetic Screening Service for Wales (DRSSW) will arrange for you to have your eyes checked every year.  It is a free service established for all eligible people registered with diabetes in Wales to reduce the risk of vision loss due to diabetic retinopathy. If you are diagnosed with diabetes, you will be referred by your GP and should receive an invitation to attend screening within 3 months of being placed on the DRSSW register. It is important to attend your regular eye screening to detect potential sight threatening retinopathy as timely treatment is highly effective in preventing its progression.

Living with

If you have type 1 diabetes, it's important to look after your own health and wellbeing, with support from those involved in your care.

Your diabetes care team

As type 1 diabetes is a long-term condition, you'll be in regular contact with your diabetes care team.

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 also be tested regularly - at least once a year - to check how well your diabetes is being controlled over the long term.

A blood sample will be taken from your arm and the HbA1c test will be 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 Diabetes UK website has more information about the HbA1c test.

Healthy eating

Eating a healthy, balanced diet is very important if you have diabetes. However, you don't need to avoid certain food groups altogether.

You can have a varied diet and enjoy a wide range of foods as long as you eat regularly and make healthy choices.

You can make adaptations when cooking meals, such as reducing the amount of fat, salt and sugar you eat, and increasing the amount of fibre.

You don't need to completely exclude sugary and high-fat foods from your diet, but they should be limited.

The important thing in managing diabetes through your diet is to eat regularly and include starchy carbohydrates, such as pasta, as well as plenty of fruit and vegetables. 

If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Diabetes UK has more dietary advice and cooking tips.

Regular exercise

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.

Exercise will affect your blood glucose level, so your care team may have to adjust your insulin treatment or diet to keep your blood glucose level steady.

Don't smoke

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.

Limit alcohol

If you have diabetes and decide to drink alcohol, avoid drinking more than the recommended daily amounts, 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.

Men and women are advised not to regularly drink more than 14 units a week. 

Keeping well

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.

Look after your feet

If you have diabetes, you're at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes.

This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves.

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.

Regular eye tests

If you have type 1 diabetes, you should be invited to have your eyes screened once a year to check for diabetic retinopathy.

Diabetic 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 lead to sight loss

The Diabetes UK website has more information about retinopathy

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 glucose levels are as well controlled as they can be before you get pregnant.

You'll need to control your blood glucose level tightly, particularly before becoming pregnant and during the first eight weeks of the baby's development to reduce the risk of  birth defects.

You should also:

  • check your medications – some tablets used to treat diabetes may harm your baby, so you may have to switch to insulin injections
  • take a higher dose of folic acid tablets. Folic acid helps prevent your baby developing spinal cord problems and it's recommended that all women planning to have a baby take folic acid. Women with diabetes are advised to take 5mg a day (only available on prescription).
  • 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.

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 helpline@diabetes.org.uk.

Financial support and benefits

If your diabetes is controlled by medication, you're entitled to free 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.

Diabetes sick day rules

If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when you're ill – known as your "sick day rules".

Contact your diabetes care team or GP for advice if you haven't received these.

The advice you're given will be specific to you, but some general measures that your sick day rules may include could be to:

  • keep taking your insulin – it's very important not to stop treatment when you're ill; your treatment plan may state whether you need to temporarily increase your dose
  • test your blood sugar level more often than usual – most people are advised to check the level at least four times a day
  • keep yourself well hydrated – make sure you drink plenty of sugar-free drinks
  • keep eating – eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier
  • check your ketone levels if your blood sugar level is high

Seek advice from your diabetes care team or GP if your blood sugar or ketone level remains high after taking insulin, if:



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 19/01/2022 15:04:16