The Friends + Family Guide To Type 1 Diabetes

If you would like to better support a friend or family member who is living with type 1 diabetes (T1D), then you’re in the right place. 

Maybe it’s your life partner, a parent whose care you’ll manage one day, a newly diagnosed child whose care you’re just starting to manage, a sibling who’s become a friend or a cousin or bestie you want to show up for differently. 

Or maybe you’re just a good human who wants to learn more. Whatever the case, this is a great place to start!

In this guide, we cover answers to frequently asked questions (FAQs) that friends and family should have the answers to, like:

• What is T1D?

• How does my loved one manage T1D?

• What devices does my loved one use to manage T1D?

• What can my friend or family member with T1D eat?

• How does T1D affect my friend or family member’s mood?

• How can I help my loved one with T1D in an emergency?

• Are there things I shouldn’t ask my friend or family member with T1D?

What is type 1 diabetes?

First thing’s first: what is T1D? T1D is an autoimmune disease that affects the pancreas. Researchers believe a number of genetic, viral or environmental factors may cause T1D. In a person without diabetes, the pancreas normally makes insulin—a hormone your body needs to turn food into energy. 

When you have T1D, your pancreas stops making insulin. Because of this, people with T1D need to inject insulin with a syringe, smart pen or dose through an insulin pump to get it into their bodies. 

They also have to carefully balance their insulin with what they eat and how active they are, all while checking their blood sugar regularly. Managing T1D is a nonstop, 24/7 balancing act. There’s no way to prevent it, and there’s no cure (yet)!

What medications and devices are used to manage T1D?

Managing T1D is a constant, 24/7 balancing act. It isn’t just about medicine; it’s about using the right tools to stay in a healthy range. Because blood sugar levels can shift throughout the day, people living with T1D rely on a few essential devices and strategies to keep everything on track.

The first things a person with T1D needs to take care of themselves well include:

• Blood sugar monitoring device: either a blood glucose meter (BGM) or a continuous glucose monitor (CGM). A BGM uses a finger-prick blood sample on a test strip to give a reading. A CGM tracks blood sugar automatically, day and night, through a small sensor worn on the body. Most people with T1D carry both—a BGM often works as a backup or a way to double-check a CGM reading.
  
• Insulin delivery device: insulin can be delivered through multiple daily injections (MDI) using a syringe or insulin pen, a smart pen or an insulin pump. A pump connects to the body, either through a tube or wirelessly, and delivers insulin continuously—at mealtimes, the person enters how much insulin they need, and the pump delivers it right away since it’s already connected. There’s no single right way to take insulin—it comes down to what works best for the person.
  
• Insulin: essential for survival with T1D, and delivered through whichever method the person prefers. There are two types: fast-acting insulin, which works quickly and is taken with meals or to bring down high blood sugar, often several times a day; and long-acting insulin, taken once a day, which releases slowly into the body over 24 hours.
  
• Glucose: needed right away when blood sugar drops too low. This includes dextrose-based gummies, tablets, powders or gels. Hard candy and juice boxes work too.
  
• Emergency glucagon: used when someone with T1D can’t treat a severe low on their own. More on how it’s delivered below.

People with T1D also need things like alcohol swabs (to keep their devices sanitary). They may even take additional “non-traditional” T1D medication with their healthcare team’s approval, such as a GLP-1 or Metformin.

If you want to help stock your friend or family member’s supply of additional things, check out our essential care kit list. You may not be able to buy their insulin at the pharmacy counter for them, but picking up some extra alcohol swabs or glucose gummies goes a long way in showing you care!

What can people with T1D eat?

The short and simple answer is: people with T1D can eat anything, as long as they dose the right amount of insulin for what they’re eating. A strict no-carb diet isn’t necessary, and it wouldn’t solve everything anyway—lots of things affect blood sugar, not just carbs. Moderation is what matters most.

There’s a healthy middle ground between only stocking the fridge with the “healthiest” foods and having lots of junk food on hand. Eating well and tracking food intake is a good idea for everyone, regardless of diabetes. But it’s important not to police what someone else chooses to eat. 

Follow your loved one’s lead when it comes to nutrition unless there are clear red flags you think you should address. Constantly policing their meals can lead to a toxic relationship with food, so focus on support rather than micromanaging to help them thrive.

How does T1D affect someone’s mood?

Blood sugar swings, whether high or low, can affect mood. Someone with T1D might seem stubborn or irritable, or they might just need a juice box. Even though T1D affects everything, not everything in life is because of T1D. Unrelated conditions, experiences or moods can co-exist in one body.

With high blood sugar, physical symptoms include:

• Nausea
• Deep or heavy breathing
• Confusion
• Flushed or warm skin
• Drowsiness

Physical high blood sugar symptoms can make a person with T1D feel:

• Short-tempered
• Crabby
• Easily angered 
• Impatient
• Restless or anxious
• Unmotivated or emotionally withdrawn

With low blood sugar, physical symptoms include:

• Shakiness
• Pale or sweaty skin
• Headache
• Hunger
• Weakness
• Trembling

Physical low blood sugar symptoms can make a person with T1D feel:

• Like they’re drunk
• Loopy/out of it
• Irritable/Snappy
• Confused/Forgetful
• Unfocused/unable to concentrate
• Overwhelmed with simple decisions
• Panicked/Anxious

T1D can be stressful, so a little patience goes a long way. As you’re starting to see, it affects everything, including mood.

How can I help my loved one with T1D in an emergency?

If someone with T1D passes out or becomes unconscious, call emergency services right away and treat the situation as a severe low blood sugar emergency (severe hypoglycemia). You may need to give emergency glucagon, either as a nasal spray (like Baqsimi®) or as an injection using a glucagon kit.

While there was only one option for decades—and it was complicated to use—there are many new and improved emergency glucagon treatment products available today, including:

• Nasal glucagon—Baqsimi®: This is an emergency glucagon that’s administered through your nose.
  
• Glucagon pen—Gvoke HypoPen®: This is a premixed glucagon injection that you press against your thigh. The auto-inject device makes it quick and easy to use. It is also available in a prefilled syringe (PFS).
  
• Glucagon Prefilled Syringe—Gvoke Kit®: This is a premixed glucagon in a vial that comes with a syringe, allowing you to draw up the dose manually and inject it directly into your thigh.
  
• Glucagon pen—Zegalogue®: Also a premixed glucagon, available as an easy-to-use auto-inject device. It is also available in a prefilled syringe (PFS).

Remember: If your loved one is conscious and able to eat or drink, they need fast-acting carbohydrates right away. If they are unconscious, they need glucagon.

Your friend or family member with T1D can work with their healthcare team to get a prescription for emergency glucagon. Once they pick it up, they should teach a few close friends or family members about how to use it. Practically speaking, it should be the people they’re around the most. If that’s you, it’s time to become a glucagon expert, friend!

Questions and comments about T1D to avoid

Now that you know the basics, it’s time to learn about what questions to avoid. Believe us, there are many! But don’t worry—if you’re new, we’ll give you a break and share the answers with you. Have some empathy for your loved one.

Here are answers to some faux-pas questions you’ll never have to ask or wonder about again after reading:

• “Are you allowed to eat that?” Yes. People with T1D can eat anything, as long as they dose their insulin correctly.
  
• Telling someone else: “Don’t let [name] have any of that.” Avoid trying to manage someone else’s diet for them. People with T1D understand how food affects their own blood sugar.
  
• Mixing up type 1 and type 2 diabetes. This is a common and understandable mix-up, but it can be frustrating and make your loved one feel less seen or understood. At its worst, it can keep stigmas and misconceptions alive that deserve to be retired.
  
• “You shouldn’t be eating that [junk food].” Trust that they’ve got it handled—people with T1D can enjoy these foods too.
  
• Assuming “no sugar” means “diabetes-friendly.” Carb counting, not just sugar content, is how people with T1D figure out how much insulin they need. Carbs matter just as much as sugar. Protein can even cause spikes in blood sugar! That doesn’t mean people with T1D need to avoid them completely. They just have to know how their body responds to different foods and eat in a balanced way.
  
• “This is sugar-free so you can have it!” Labels like “sugar-free,” “low fat” and “low carb” can be misleading—these foods can still affect blood sugar, too.
  
• “But you’re so healthy and active!” T1D isn’t caused by lifestyle or health choices. It happens because the body can’t make insulin. On that note, let’s also make another thing clear: all different body types have T1D. Not just “skinny” or “obviously fit” people.
  
• Jokes like “I just ate so much dessert, I’m going to get diabetes.” These aren’t accurate, and they aren’t funny to people living with any form of diabetes. People living with all types of diabetes are often some of the healthiest out there because they have to be hyper-attuned to their bodies or their bodies will go out of whack.
  
• “I could never do that!” (Manage all the injections, pokes and pricks.) You would do it too, if you had to. This is perhaps one of the most unintentionally annoying comments a person with T1D can be asked.
  
• Trying to act as their doctor, nutritionist, counselor or nurse. You’re not. Don’t do it, please.

Think before you ask (but still ask!)

Sharing this list of questions to avoid isn’t meant to scare you into not connecting with or asking your loved one about their T1D. It’s simply to encourage some thoughtfulness around how some questions might land with the average person with T1D. 

Finding the “right” questions or the “right way” to ask them may also depend on your relationship with your loved one. You know your dynamic! Suss it out. And if you make a mistake, just own it and move forward together.

Most people with T1D would rather you ask than avoid. People with T1D want to feel normal, not more isolated from you. Walking on eggshells around a person with T1D is never the vibe!

Type 1 diabetes is a personal disease and experience

Everyone’s T1D routine, journey and mindset is different. It can be frustrating when others try to dictate what someone with T1D can or can’t do, or what they should do if they’re feeling sick. Likewise, it can be challenging when someone pushes loved ones to behave a certain way. You’re on this journey together and can figure it out together. 

Consider this your starting point, not hard-and-fast rules for building a better relationship and support system for your friend with T1D! The best thing a friend or family member can do is offer support and help, without being pushy.

Find all our guides to relationships in life with T1D here.

Ready to go above and beyond for your loved one? Dive into the beginner’s guide to T1D here.