Type 1 Diabetes Mellitus, Self-Care, Adult

• Insulin.
• Nutrition.
• Exercise.
• Lifestyle changes.
• Other medicines, if needed.
• Support from your team of health care providers and others.

The following information explains what you need to know to manage your diabetes at home.

What are the risks?

Having diabetes puts you at higher risk for other long-term (chronic) conditions, such as heart disease and kidney disease. These problems can get worse if you do not keep your blood glucose within the target range.

How to monitor blood glucose

• Check your blood glucose levels frequently by using either a blood glucose meter or a continuous blood glucose monitor or as told by your health care provider.
• Have your A1C (hemoglobin A1C) level checked two or more times a year, or as often as told by your health care provider.
• Your health care provider will set individualized treatment goals for you. Generally, the goal of treatment is to maintain the following blood glucose levels:
  • Before meals (preprandial): 80–130 mg/dL (4.4–7.2 mmol/L).
  • After meals (postprandial): below 180 mg/dL (10 mmol/L).
  • Hemoglobin A1C level: less than 7%.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Take your insulin and other medicines every day as told.
• Do not run out of insulin or other medicines that you take. Plan ahead so you always have these available.
• Adjust your insulin delivery system (insulin pump) or dosage based on how physically active you are and what foods you eat. Your health care provider will tell you how to adjust your dosage.

Eating and drinking

What you eat and drink affects your blood glucose and insulin dosage. Making good choices helps to control your diabetes and prevent other health problems. A healthy meal plan includes eating lean proteins, complex carbohydrates, fresh fruits and vegetables, low-fat dairy products, and healthy fats.

Make an appointment to see a registered dietitian to help you create an eating plan that is right for you. Make sure that you:

• Follow instructions from your health care provider about eating or drinking.
• Drink enough fluid to keep your urine pale yellow.
• Monitor how many grams of carbohydrates you eat. You can do this by learning how to count carbohydrates, by reading food labels, and by learning the standard serving sizes of food.
• Follow your sick-day plan whenever you cannot eat or drink as usual. Make this plan in advance with your health care provider.

Always have a 15-gram rapid-acting carbohydrate snack with you to treat low blood sugar (hypoglycemia).

Activity

• Exercise regularly, as told by your health care provider. This may include:
  • Stretching and doing strength exercises, such as yoga or weight lifting, 3 or more times a week.
  • Doing 150 minutes or more of moderate-intensity exercise or 75 minutes or more of vigorous-intensity exercise each week. This could be brisk walking, biking, or water aerobics.
    • Spread out your activity over 3 or more days of the week.
    • Do not go more than 2 days in a row without doing some kind of physical activity.
• When you start a new exercise or activity, work with your health care provider to adjust your insulin or food intake as needed.

Lifestyle

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.
• Do not drink alcohol if:
  • Your health care provider tells you not to drink.
  • You are pregnant, may be pregnant, or are planning to become pregnant.
• If your health care provider says that alcohol is safe for you:
  • Limit how much you have to:
    • 0–1 drink a day for women.
    • 0–2 drinks a day for men.
  • Know how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).
• Learn to manage stress. If you need help with this, ask your health care provider.

Care for your body

• Keep your immunizations up to date. In addition to getting vaccinations as told by your health care provider, it is recommended that you get vaccinated against:
  • The flu (influenza). Get a flu shot every year.
  • Pneumonia.
  • Hepatitis B.
• Schedule an eye exam within 5 years after your diagnosis. Depending on the results of the eye exam, schedule another exam 1–2 years later.
• Check your skin and feet every day for cuts, bruises, redness, blisters, or sores. Schedule a complete foot exam 5 years after your diagnosis, and then every year after the first exam.
• Brush your teeth and gums twice a day, and floss one or more times a day. Visit your dentist one or more times every 6 months.
• Maintain a healthy weight.

General instructions

• Share your diabetes management plan with people at work, school, and home.
• Family members and close friends should:
  • Learn the symptoms of hypoglycemia.
  • Understand how to treat hypoglycemia in case you cannot treat it yourself.
• Check your urine for ketones when you are ill and as told by your health care provider.
• Carry a medical alert card or wear medical alert jewelry.
• Keep all follow-up visits. This is important.

Questions to ask your health care provider

• Do I need to meet with a certified diabetes care and education specialist?
• Where can I find a support group for people with diabetes?
• Do I need to have an emergency glucagon kit available?

Where to find more information

• American Diabetes Association (ADA): diabetes.org
• Association of Diabetes Care and Education Specialists (ADCES): diabeteseducator.org
• International Diabetes Federation (IDF): idf.org

Get help right away if:

• Your blood glucose level is below 54 mg/dL (3 mmol/L).
• You have moderate or large ketone levels in your urine.

• Do not wait to see if the symptoms will go away.
• Do not drive yourself to the hospital.

Summary

• Caring for yourself after you have been diagnosed with type 1 diabetes (type 1 diabetes mellitus) means keeping your blood sugar (glucose) within the target range. You can do this with a balance of insulin and other medicines, nutrition, exercise, lifestyle changes, and support from others.
• Having diabetes puts you at higher risk for other health problems. These can get worse if you do not keep your blood glucose under control.
• Check your blood glucose levels frequently.
• Keep all follow-up visits. This is important.