Type 1 diabetes

Symptoms of type 1 diabetes include peeing more than usual, feeling very thirsty and very tired, and losing weight.

Type 1 diabetes is diagnosed based on your symptoms and by using blood tests to check for high blood glucose.

The main treatment for type 1 diabetes is taking insulin to manage your blood glucose. You'll have regular check-ups and be offered courses to help.

Type 1 diabetes can increase your risk of getting other long-term health problems, such as heart disease and problems with your feet, eyes or nerves.

If you have type 1 diabetes, you can help avoid problems by monitoring your glucose levels carefully and treating them when they're low or high.

The most common symptoms of type 1 diabetes are:

• peeing more than usual, especially at night
• feeling very thirsty and drinking more than usual
• feeling very tired
• losing weight without trying to or looking thinner

Children may have heavier nappies or they may start wetting the bed because they're peeing more.

The easiest way to remember these symptoms is the 4 Ts: toilet, thirsty, tired, thinner.

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 or infections that do not get better, such as thrush or nappy rash

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.

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

If tests show you or your child might have type 1 diabetes, you'll need to see a specialist in hospital to start treatment and have more tests. This is usually on the same day.

A diabetes specialist will usually confirm whether you have type 1 diabetes or another type of diabetes based on your age, weight and symptoms.

If it's not clear which type you have, or the tests do not show you have diabetes, you may need extra blood tests.

Children may also be unwell with things like a cold, tonsilitis, tummy pain or nappy rash when they first get diabetes symptoms. This can make it harder to diagnose.

If you think your child might have diabetes, you can ask a GP to do a finger-prick glucose test. It can help to bring a sample of your child's pee to the GP appointment.

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 will 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.

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

Managing type 1 diabetes can be a challenge and take time to get used to. Constantly trying to meet blood glucose targets can lead to a feeling of burnout.

You'll need to do more planning for things like school or work, travel, eating out and exercise.

But with the right treatment and support, you can eat normally, continue with your usual work and still do all the things you enjoy.

Type 1 diabetes can increase your chance of getting other health problems (long-term complications), such as heart disease, nerve damage and problems with your eyesight. But you'll be given care to help prevent these.

You can also lower your chance of getting complications by managing your blood glucose levels as well as you can.

People with type 1 diabetes also have a higher chance of getting other conditions caused by problems with your immune system (autoimmune conditions), such as thyroid disease, coeliac disease and Addison's disease.

Diabetes treatments and technologies are improving, so people diagnosed with type 1 diabetes today should be able to expect a better quality of life than was possible before.

Many people with type 1 diabetes are able to avoid complications and have long, healthy lives.

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.

It's important to go to all of your diabetes appointments and make sure you do not miss any tests, as these can help find and treat any complications as soon as possible.

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 will 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

• you have any pain, tingling, numbness or blisters in or on your feet

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.

You notice changes to your sight, including:

• your vision getting worse
• finding it more difficult to see in low light
• shapes floating in your vision (floaters)

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.

Type 1 diabetes can be a difficult condition to deal with, both physically and emotionally.

As well as support from your diabetes team, you may find it helpful to get support from other people with type 1 diabetes, either at a local support group or online.

There are also national diabetes charities that can offer support.

Get help from NHS talking therapies

Having type 1 diabetes can affect your mental health. It might help to talk about how you're feeling.

There may be a mental health specialist on your diabetes team, or your team or GP may be able to refer you.

You can get talking therapies for free on the NHS. These services can help you find ways to cope.

Help is available in person, by video, over the phone or as an online course.

Diabetes UK

Information and support for anyone with diabetes, including support groups, online communities, and courses and tools for managing diabetes.

• Website: www.diabetes.org.uk
• Helpline: 0345 123 2399
• Email: helpline@diabetes.org.uk
• Diabetes UK: local support groups
• Diabetes UK: forum

Breakthrough T1D

Information and support for people with type 1 diabetes.

• Website: www.breakthrought1d.org.uk
• Phone: 020 7713 2030
• Breakthrough T1D: guide for newly diagnosed adults
• Breakthrough T1D: guide for parents and carers

DigiBete

Videos and app for children and young people with type 1 diabetes.

• Website: www.digibete.org