The Friends & Family Guide to Type 1 Diabetes

Editor’s Note: This content is a part of Beyond Type 1’s guidebook, which includes guides for everyone who has a type 1 in their life. Check out the rest of our customized guides for the different people in your life here!

Maybe it’s the friend’s child next door or a member in the family who has type 1 diabetes. Perhaps you’ll be in charge of care at some point or are simply interested in learning more about type 1 (T1). Consider this guide to help you navigate type 1 as a friend or family member.

What is Type 1?

Type 1 diabetes is an autoimmune disease that affects a person’s pancreas. The pancreas is responsible for producing insulin, a hormone people need to get energy from food. Our pancreas, for reasons that have not been identified, does not produce any insulin. As a result, we need to inject or continually infuse insulin through a pump and carefully balance our insulin doses with eating and daily activities. We must also regularly monitor our blood-sugar levels. Type 1 is a non-stop and 24/7 balancing act that we must maneuver every day. There is no way to prevent type 1 and there is no cure (currently!).

How do you manage it?

We get by with a little help from our friends! These include our blood glucose meter, insulin, needles and monitors. The glucose meter is a device that measures blood sugar. We use a device that pricks our finger and we put the blood sample onto a test strip. From there, the test strip is read by the meter and gives us a number on the meter screen.

We can get insulin into our bodies through multiple daily injections or an insulin pump.

Injections are delivered to our bodies through insulin pens and needles. There are two types of insulin that we use. Fast-acting insulin gives our bodies insulin right away and is taken with meals or to correct a high blood sugar. Fast-acting insulin is used multiple times a day, depending on when you eat. The other is long-acting insulin, which is given once a day. Long-acting insulin is a slow release insulin that is given to your body in a span of 24 hours when needed.

An insulin pump is a device that is connected to the body, either through a tube or wirelessly. With the control of a device, you are constantly getting insulin through the pump. During meals, we can choose how much insulin to give, and the device is already in our skin and ready to deliver the amount needed.

What are the devices that you use?

CGM, or continuous glucose monitor, measures blood glucose levels in real-time throughout the day and night. The CGM sensor is inserted under the skin to measure blood glucose levels in fluid tissue. The sensor is connected to a transmitter that sends the information to a display device. It is common for many people to have the CGM results sent to their iPhone, Android, or Apple Watch.

An insulin pump is the other device that is connected to the body and delivers insulin to the body.

What can you eat?

People with type 1 can eat anything that they choose to eat, as long as they correctly dose the amount of insulin needed for the food that is eaten. Although someone might assume that sticking to a strict no-carb diet would help us, there are MANY other things that affect our blood sugar. Everything in moderation!

There is a happy medium in between stocking your fridge with the healthiest foods and having all of the donuts, candy and chocolate available. For any person, eating healthy is the best way to feel better. However, it is important to not force any type of food choices to someone.

How might it affect our mood?

Be aware that our mood might be based on blood sugar levels, high or low. We may be very stubborn or crabby, or we may just need a juice box. Type 1 can be stressful at times, so bear with us! Here are the symptoms of highs and lows.

• High symptoms: nausea, deep sighing breaths, confusion, flushed and warm skin, drowsiness
• Low symptoms: shaky, pale and sweaty skin, headache, hunger, weakness, trembling

General Treatment

The day in the life of someone with type 1 involves frequent blood sugar testing and insulin treatment. Insulin treatment is not a cure for type 1; insulin is used to control our blood sugar. High or low blood-sugar levels can be common, even on a daily basis.

What do you do in case of emergency?

In case of an emergency, there are few things to do. If we are ever passed out or unconscious, immediately call emergency services and react to the situation as if we were “having a low” or experiencing severe hypoglycemia. If we are unconscious, you may have to administer emergency glucagon, either nasal glucagon BAQSIMI or with injectable glucagon via a Glucagon kit. If we are conscious, fast-acting glucose needs to be taken immediately. This means juice boxes, candy, glucose tablets, or any other sugary food or drink that can be consumed easily.

Top questions/comments to avoid

1. “Are you allowed to eat that?” Yes, we can eat anything as long as we correctly dosage our insulin.
2. To another person: “Don’t let (insert name) have any of that.” Steer clear of trying to micromanage our diets. We have a good understanding of what foods can do to our blood sugar.
3. Mixing up type 1 and type 2 – This is a very frustrating and common mistake that is easy to make for someone who isn’t familiar with diabetes. All of the jokes and movie references that you have seen about diabetes are most likely inaccurate and exaggerated.
4. “You shouldn’t be eating that dessert/pizza/pasta/sweet food.” Maybe you should trust that we are on top of it! We can enjoy these types of foods!
5. Sugar vs. Carbs – If a food doesn’t have any sugar, that doesn’t mean that it is a type 1’s dream food of choice. “Carb counting” is a term that type 1s go by when deciding how much insulin is needed for a meal. In other words, look at the carbs and sugar content of a food before saying anything!
6. “This is sugar-free, so you can have it!” “Sugar-free”, “low fat” and “low carb” are all labels that may seem ideal, but can be hidden with other triggers that can affect our blood sugar.
7. “But you are so healthy and active!” We didn’t get type 1 from our health choices! We got type 1 because our bodies physically cannot make insulin.
8. Any and all “I just ate so much dessert so I will get diabetes” jokes. They aren’t funny to us, and they also are not true.
9. “Do the injections hurt?” We are very tough people, and these injections are a daily part of our lives. We take care of our bodies and handle the injections with strength.
10. Trying to act as a doctor, nutritionist, counselor, or nurse.
    Everyone’s type 1 routine is individual. It is frustrating when other people try and tell us what we can and cannot do, or what we should do if we are feeling sick. The most important thing that a friend or family member can do is to be supportive and helpful without being pushy.

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