Cornerstones of management
Some people’s bodies, often children and teenagers, cannot produce insulin, a hormone that helps to control blood sugars. This is called type 1 diabetes.
The cornerstones of managing type 1 diabetes are:
- Taking insulin and monitoring blood sugar levels
- Meal planning and carbohydrate (carb) counting
- Lifestyle management: healthy eating, physical activity, and managing stress
It starts with insulin
Insulin is the main strategy used to manage type 1 diabetes, as it helps the body to use glucose (sugar) as energy. Insulin is taken multiple times each day and the amount of insulin used changes depending on your blood sugar levels. There are a number of different types of insulin available to help control blood sugars.
Without insulin, blood sugar levels can increase, which can lead to complications.
Speak to your physician or diabetes healthcare team for more information about the details of your insulin regimen.
Keeping on top of blood sugar levels
In addition to taking insulin, as mentioned above, it is important to monitor your blood sugar levels using a blood glucose meter. Each person has a specific target blood sugar level. To feel your best, it is important to keep your blood sugar within this target range. There are two blood sugar levels that should be monitored. For most people, the target fasting or ‘before meal’ blood sugar level is 4-7 mmol/L and the recommended ‘2-hour after meal’ blood sugar level is 5-10 mmol/L.
Blood sugars can also be measured by doing a test called an A1C. This blood test is done at the lab and shows your average blood sugar level over the past 2 to 3 months.
Why carbohydrates matter – meal planning and carb counting
Carbohydrates have a larger impact on blood glucose compared to other food groups such as proteins and fats.
What is carb counting? This is a meal planning technique where your dose of insulin is chosen based on the amount of carbs in a meal. The balance between the carbs you eat and the insulin in your body affects how much your blood sugars rise after a meal. Counting carbs can help you decide how much insulin to take.
What other lifestyle changes are important?
Since what you eat impacts your blood sugar levels, eating well-balanced meals is essential for diabetes management. This means choosing a variety of foods, from each of the major food groups. Some key tips include:
- Eat three meals a day
- Limit sweets and sugar-sweetened beverages
- Choose fish, poultry, beans and nuts more often
- Eat more vegetables, fruits and whole grains
- Limit foods that are high in saturated fat
A regular physical activity routine helps your insulin work better and lowers your blood sugar. Children over 5 should get at least 60 minutes of moderate- to vigorous-intensity physical activity each day. Adults should aim for 150 minutes of moderate-to-vigorous activity per week. It’s also recommended that resistance exercise such as weight training be added to increase muscle and bone strength at least 2-3 times per week.
With type 1 diabetes, the effects of exercise on blood glucose levels are a little more complicated and need to be carefully monitored. Your diabetes healthcare team should be consulted.
Diabetes management in itself can be stressful, and excessive stress is a major barrier to effective glucose control. It is important to speak to your diabetes health care provider regarding strategies to minimize stress. In the meantime, you can try some of these strategies:
- Identify the things that are causing stress and see if any can be controlled or changed
- Get physically active – evidence shows that it truly does relieve stress
- Learn relaxation techniques
- Schedule ‘me time’ into your routine
- Connect with others – chat with friends or join a support group
You are the most important member of the team
Additionally, if you have questions about type 1 diabetes, there are many different health care professionals that can help you. This may include a family doctor, dietitian, or a foot or eye care specialist. You will be the one making day-to-day decisions, so it is important to ask questions from the diabetes team. The more you know, the easier it will be to manage your diabetes.