10 Things to Know If You’ve Been Diagnosed with Type 1 Diabetes

1. Chill Out! No One Becomes a Diabetes Ninja Overnight

First, give yourself a moment. Or ten. A type 1 diabetes diagnosis might be overwhelming now, but allow yourself some breathing room and take things one step at a time. 

Even though type 1 diabetes is a lifelong condition, it’s one you can live well with into old age. Thousands of people with T1D run marathons, raise families, travel the world, start companies (ahem…TCOYD®), become professional athletes, fly commercial airlines, become Elvis impersonators – you name it! 

2. Find a Knowledgeable Healthcare Team

In the old days, people had a dedicated diabetes care team, but that’s a little more difficult to come by with the medical system we have today. That said, in addition to your primary care doctor, you should try to see an endocrinologist with an interest in type 1 diabetes. Some endos like to focus on thyroid conditions, adrenal disorders, infertility, etc., so it’s important that you see a diabetes endocrinologist. You should also have annual visits with an ophthalmologist or optometrist who’s experienced in diabetic eye disease.

Other providers who can help with various aspects of diabetes management:

• A certified diabetes care and education specialist (CDCES)
• A nutritionist or registered dietitian
• A mental health professional who can provide emotional support if you need it
• A personal trainer 

Your medical team can help you figure out how much daily insulin you need, how to adjust your insulin doses for meals, activity, stress, and illness, how to troubleshoot highs and lows, and how to deal with diabetes burnout or any other challenges you might have. Don’t be afraid to ask questions, speak up if you’re confused, and advocate for what you need.

3. Choose Your Insulin Regimen

Insulin is a hormone that helps move sugar (glucose) from your bloodstream into your cells for energy. Without insulin, your blood sugar shoots up. So now you’ll need to give your body the insulin it needs – through injections, an insulin pen, or an insulin pump.

There are two main categories of insulin:

• Basal insulin (also called long-acting insulin): This is the background insulin your body needs all day and night to keep blood sugar steady. Unlike mealtime insulin, which works quickly to cover the food you eat, basal insulin works slowly and steadily over many hours. 
• Bolus insulin (also called fast-acting insulin): This insulin handles the rise in blood sugar that happens when you eat. You might also use a bolus dose to bring down high blood sugar (correcting for a high). Think of it as the “extra boost” that steps in when your blood sugar needs more immediate help.

The two best basal insulins are Tresiba and Toujeo because neither has a peak (something you do NOT want in a basal insulin), and they only need to be taken once a day. 

There are lots of different brands of fast-acting insulin, including:

• Novolog
• Fiasp (slightly faster-acting than Novolog)
• Humalog
• Lyumjev (slightly faster-acting than Humalog) 
• Much older “regular” insulins like Humulin R and Novolin R, which are still available (and much cheaper if cost is an issue)
• Inhaled insulin Afrezza, which gets into your system fast and gets out of your system fast, so you have less chance for hypoglycemia 

Your doctor will help you determine the most appropriate insulin type, dosage, and administration schedule. 

Most people with a new type 1 diabetes diagnosis are put on multiple daily injections right away, but we recommend you consider going on an automated insulin delivery pump system (also called an AID system or a hybrid closed-loop system). 

These are insulin pumps that communicate with a continuous glucose monitor (see # 4 below). AID systems can give you the right amount of insulin automatically, helping to keep your blood sugar in range without you having to do all the work yourself. 

4. Get a Continuous Glucose Monitor: The Crystal Ball of Blood Sugars

Outside of insulin, a continuous glucose monitor (CGM) is the single most important tool for your diabetes management. It’s a small device you wear on your body that tracks your blood sugar 24/7 so you don’t have to prick your finger. It sends blood sugar readings to your phone (or a receiver), showing you not just where your blood sugar is right now, but also where it’s headed so you can catch highs or lows before they sneak up on you. 

CGMs also have alerts and alarms to tell you if your blood sugar is getting too high or dangerously low. You can share your data with your doctor and your loved ones (but not your ex-wife!) if you want to.

Pairing a CGM with an insulin pump can take a lot of the guesswork out of managing T1D and give you more freedom to live your life. 

5. Know the Signs of Hypoglycemia and How to Treat It

When your blood sugar is between 70-180 mg/dL, this is what we call “in range.” When blood sugar dips below 70 mg/dL, that’s called hypoglycemia or low blood sugar.

Symptoms of hypoglycemia include:

• Shakiness or trembling
• Sweating (even in a cool environment)
• Hunger
• Fast heartbeat
• Irritability
• Anxiety
• Pale skin
• Headache
• Dizziness or lightheadedness

Symptoms of low blood sugar can vary from person to person – some people may not feel low until their glucose hits 65 mg/dL, while others may start having symptoms at 75 mg/dL.

Generally speaking, mild or moderate hypos can be treated with fast-acting carbs like glucose tablets, jelly beans, apple juice, orange juice, etc.

If you have severe hypoglycemia (that’s when you typically need help from someone else), you may need to bring out the big guns – glucagon.

The newest glucagon options are the Gvoke HypoPen, an injection that can be given in the lower abdomen, outer thigh, or upper arm, and BAQSIMI, a glucagon nasal spray. Since someone else will likely be the one giving the glucagon to you, make sure your friends, family, coworkers, teachers, etc. know how to use it—and where you keep it.

A backup blood glucose meter is also a lifesaver if your CGM fails (which can happen) or your physical symptoms don’t match your CGM readings.

While you’re loading things in your Amazon cart, consider getting a ketone meter (with ketone strips) too. Rising ketones mean your body isn’t getting enough insulin, which can lead to diabetic ketoacidosis (DKA), one of the complications of diabetes. Continuous ketone monitoring is on the horizon and will hopefully soon be implemented into the FreeStyle Libre CGM brand, so eventually you won’t need an extra device and strips.

6. Carbs and Cocktails Can Still Be on the Menu

Yes, you can still eat carbs after a type 1 diabetes diagnosis, but most people find that eating low-carb (ish) makes managing diabetes a lot easier. You’ll have to find what works for you. This is when a nutritionist, dietitian, or CDCES can be a big help. There are also a lot of apps out there that can help you determine the amount of carbs you’re eating.

In reality, counting carbs usually ends up being more of a WAG (wild-ass guess) than an exact science, even for people who’ve had diabetes for years. Eventually, you’ll learn how different foods affect your blood sugar, and you’ll get better at predicting the amount of insulin you need. Giving yourself a bolus of insulin about 20 minutes before you eat can really help with post-meal blood sugar spikes.

If you like to partake in adult beverages, watch our video on drinking with diabetes to learn how different types of alcohol can impact blood sugar (and how many drinks it takes for endocrinologists to lose their shirts).

7. Everyone Rides the Blood Sugar Rollercoaster…We’ll Save You a Spot! 

Blood sugar levels can go up and down for all kinds of reasons besides food – like exercise, stress, sleep, hormones, heat, someone giving you side-eye at the grocery store – you get the idea. Don’t beat yourself up when your numbers bounce around. It’s totally normal, and it happens to everyone with diabetes.

There are a few tricks of the trade that can help control blood sugar spikes after eating and manage blood sugar during exercise, including insulin timing, splitting your meal, and adjusting your pump settings. 

8. Join a Diabetes Support Group and Find Your People

T1D can feel like you’re living on an island all alone, but there’s a huge community of people around the world who are all in the same boat. Connect with others on social media, through national organizations like Breakthrough T1D, in local diabetes support groups, through type 1 diabetes adventure experiences, and at in-person events like our annual ONE Conference and Retreat. There are an estimated 9.5 million people with T1D globally, so your chances of finding a new diabuddy are pretty good!

T1D communities can help you feel understood, offer tips and emotional support, offer advice on diabetes burnout, and remind you that you’re never alone in this.

9. Know the Long-Term Diabetes Complications (and How to Prevent Them)

When you’re newly diagnosed, the scary stuff (like diabetes complications) isn’t something you need to lose sleep over. Complications usually take years and years of consistently high blood sugars to develop. 

Still, it’s smart to know what’s on the list: things like nerve damage, kidney disease, heart issues, and vision changes. The good news? Keeping your blood sugar in range as much as possible offers major protection against all that.

Other things that can contribute to complications of diabetes include:

• Blood pressure
• Obesity
• Lifestyle (smoking and excessive alcohol intake)
• Genetics
• Exposure to toxins and dyes, chemotherapy, and vitamin deficiencies 

Regular checkups, screening, staying on top of your care, and taking action early all add up to better outcomes when it comes to diabetes complications. 

We call this the diabetes warranty program. Just like a warranty for your car, if you follow the regularly scheduled maintenance, your car (you) will run better and last longer.

10. Learn All You Can about Your Condition – Knowledge Is Power!

Type 1 diabetes isn’t caused by eating too much sugar, and you didn’t do anything wrong to “get” it. It’s an autoimmune condition that happens when your immune system mistakenly attacks and destroys the insulin-producing cells in your pancreas. 

When you take responsibility for your own care early on, the better your health is likely to be. Take a deep dive into the articles and videos on our website, explore our YouTube channel, join diabetes support groups in person or online, find a diabetes educator familiar with type 1…whatever you do, get yourself educated and don’t solely depend on your doctor to do all the heavy lifting when it comes to your health.

Bring your friends and family into the loop too, and let them know how you would like to be supported. Having at least a few people in your circle who understand what T1D is (and what to do in case of a low blood sugar emergency) can give you peace of mind and be a boost when you need it.