Treatment for type 1 diabetes

Main treatments for type 1 diabetes

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.

Insulin

Insulin is a medicine that reduces your blood glucose (sugar).

There are different types of insulin, taken at different times. You'll need to calculate how much you need and inject it several times a day using an insulin pen, or use an insulin pump.

Too much insulin causes hypoglycaemia, or hypos. You'll be taught how to recognise the symptoms and how to treat a hypo.

Your diabetes care team will help you find the insulin routine that's best for you.

If you have type 1 diabetes, you're entitled to free prescriptions for all your medicines.

Insulin pumps

An insulin pump is a small device you attach to your skin and wear all the time. It gives you tiny amounts of insulin throughout the day and night. This can reduce hypos and improve your blood glucose levels, compared to insulin injections.

You may be able to get an insulin pump on the NHS if:

• you cannot reach your target average blood glucose level (HbA1c level) without having serious problems with hypos
• your HbA1c levels are too high despite carefully trying to manage your diabetes

Pumps are also recommended for children under 12 years old who cannot easily have injections several times a day.

Hybrid closed loop systems

Some types of insulin pump work with a continuous glucose monitor to automatically give you the right amount of insulin based on your blood glucose levels. This is called a hybrid closed loop system.

A hybrid closed loop system can reduce hypos, improve your blood glucose levels and reduce the burden of managing diabetes.

Hybrid closed loop systems are gradually being made available on the NHS.

You may be able to have one if:

• you're under 18 years old
• you're pregnant or planning to get pregnant
• an insulin pump or continuous glucose monitor on its own is not working well enough to reduce your blood glucose or prevent serious problems with hypos

Appointments and tests

You'll have a diabetes check-up at least once a year, and more often when you're first diagnosed.

This will include checking:

• your blood glucose levels for the past 8 to 12 weeks (HbA1c test)
• your weight, BMI, cholesterol, blood pressure, kidneys and thyroid
• your wellbeing and mental health

You'll also be offered:

• an HbA1c test every 3 to 6 months
• diabetic eye screening every 1 or 2 years to check for problems with your sight (diabetic retinopathy)
• a foot check-up every year by your diabetes nurse or a foot specialist – this is sometimes done at your yearly diabetes check-up

Children under 12 years old will not need all of these tests.

Diabetes courses

Diabetes courses are recommended for everyone with type 1 diabetes. They're designed to give you the confidence and skills you need to manage diabetes.

You should be offered a free group course within 1 year of being diagnosed. There are also online courses that you can do at your own pace.

Diabetes courses include:

• DAFNE (Dose Adjustment for Normal Eating) – face-to-face or remote group courses
• BERTIE Diabetes – online courses
• My Type 1 Diabetes – online courses