Simple steps: Living with type 1 diabetes

Once you’ve been diagnosed with type 1 diabetes, and learned how to recognise the symptoms of high and low blood sugar levels and treat them, the next step is understanding how to live with your diabetes.

And it’s an important step.

Type 1 diabetes can cause several long-term complications, including problems in your eyes, kidneys, feet and heart. But by following a type 1 diabetes diet plan, exercising regularly, and sleeping right, you can help reduce your risk of complications.

Useful things to know include:

Food

Exercise

Lifestyle

Food

What is a type 1 diabetes diet?

“Do I need to follow a diabetic diet?” and “What is a type 1 diabetes diet?” are common questions for newly diagnosed type 1 diabetics.

However, the truth is that as a type 1 diabetic you can actually still eat anything you want. You’ll simply need to adjust your insulin doses to match and counteract the amount of sugar and carbohydrates you eat.

It’s still a good idea to eat healthily and make smart food choices, though. Because making healthy food choices every day can have both immediate and long-term benefits.

It’s also a good idea to talk to a dietitian or a diabetes educator. With some education and practice, you can eat well and control your diabetes.

What is the best diet for type 1 diabetes?

The best diet for type 1 diabetes is typically one that’s low in carbohydrates. This is because carbohydrates are converted by your digestive system in sugar, and are then absorbed into your bloodstream – They raise your blood sugar level faster than any other food (though this can be useful if your blood sugar level is low, and you need to increase it quickly).

The three types of carbohydrates are starches, sugars and fibre. These types of carbohydrates are found in rice, beans, starchy vegetables, fruits, pasta and bread.

Whole grains

Whole grains are nutritious and contain lots of fibre. They also contain ‘complex carbs’ that take your body longer to digest - This is good, because it means you won’t get sudden blood sugar level increases.

Brown rice is a whole grain and a great alternative to white rice. It has more fibre than white rice and more nutrients too. Other whole grains you should look to bring into your type 1 diabetes diet include:

  • bran cereal
  • oats
  • barley
  • and quinoa.

Vegetables

Vegetables are a key part of a healthy diet, but some are better for a type 1 diabetes diet than others.

Starch is a type of carbohydrate, and starchy vegetables such as potatoes, corn and peas will increase your blood sugar level – You can still eat them, but in moderation.

Non-starchy vegetables are a good choice for a type 1 diabetes diet, and include:

  • asparagus
  • beans
  • broccoli
  • cabbage
  • carrots
  • eggplant
  • mushrooms
  • okra
  • onions
  • peppers
  • radishes
  • and zucchini

Non-starchy vegetables have little effect on your blood sugar and are typically rich in vitamins, minerals, fibre and phytochemicals.

Fruits

Fruits are high in natural sugar (another type of carbohydrate). So, if you eat a lot of fruits, you may find you’ll have a high blood sugar level. However, because most fruit is high in fibre, it takes longer for your body to digest – Again, this is good because it means you shouldn’t get sudden blood sugar level increases.

Fruits are also rich in vitamins and minerals, and so are a great addition to a type 1 diabetes diet.

Try to eat fresh, frozen or canned fruit. If you’re eating canned fruit, avoid any that have been packed in fruit syrup as this will have high levels of sugar in it.

Good fruits to include in a type 1 diabetes diet are:

  • Apples
  • Apricots
  • Bananas
  • Cherries
  • Grapes
  • Mangoes
  • Oranges
  • Papayas
  • and peaches

You can also eat dried fruits like dates, figs, raisins, cherries, and cranberries.

Just remember to keep track of the number of carbohydrates in your fruits, and this will help you manage your insulin and blood glucose levels.

Proteins and fats

It’s important to include proteins in your type 1 diabetes diet, as well as healthy fats. This will help you build muscle, heal wounds, and lower the chance of developing heart disease.

Good sources of proteins include:

  • beans
  • eggs
  • and meat

When it comes to healthy fats, you should look to include unsaturated fats in your type 1 diabetes diet. Saturated fats are high in cholesterol, and can increase your risk of heart disease, but unsaturated fats can lower cholesterol and help protect your heart.

You can find healthy fats in:

  • avocado
  • nuts
  • olive oil
  • and seeds

Managing your carbohydrates

By keeping track and limiting the number of carbohydrates in your diet, you can avoid sudden changes in blood sugar level and make your diabetes easier to manage.

This is why many diabetics use a technique called ‘carb counting’. Carb counting involves calculating the number of carbohydrates in your meal, and then working out from that how much insulin you should take to match and counteract the carbs – It’s based on your unique insulin to carbohydrate ratio (ICR), which is the number of carbohydrates that would be covered if you took 1 unit of insulin.

What’s a glycemic index, and why does it matter for type 1 diabetics?

Counting carbs is a great way to work out how much insulin you need to take to keep your blood sugar levels stable. However, not all carbohydrates are digested at the same rate. This means not only do you need to know how much insulin you have to take, you also need to know when you should take it.

This is where the glycemic index comes in.

The glycemic index (GI) is an internationally standardised way of reporting how carbohydrates are absorbed and broken down by your body. It’s measured between 0 and 100:

  • Low GI: Less than 55.
  • Mid GI: 56 to 69.
  • High GI: Over 70.

Foods with a low GI score contain carbohydrates that are absorbed and digested slowly, leading to a slow and gradual increase in blood sugar level.

Foods with a high GI score contain carbohydrates that are absorbed and digested quickly, which can lead to a sudden, sharp increase in blood sugar level.

Knowing whether the food you’re about to eat has a high or low GI will help you effectively plan how much insulin to take, and also better monitor and understand your blood sugar level.

Dairy and type 1 diabetes

Cows’ milk is a great source of energy and calcium, but it has been suggested that it could increase the risk of autoimmune diseases, including type 1 diabetes.

Importantly though, this has not been proven and the research is inconclusive. There simply isn’t enough evidence to confirm that dairy and type 1 diabetes have any kind of connection.

Sugar and sugar substitutes

A common misconception is that sugar causes diabetes. However, type 1 diabetes isn’t caused by diet – It’s generally believed to be caused by a genetic predisposition, other autoimmune conditions, or possibly viral infections.

As a type 1 diabetic, you can still eat sugar. You’ll need to take more insulin to counteract it and keep your blood sugar level stable, so you should eat sugar in moderation.

You can also try sugar substitutes, or artificial sweeteners, which will make your food sweeter without driving your blood sugar level up. Sugar substitutes available in India include:

  • Sweet n Low
  • Sugar Free
  • Equal
  • BeStevia
  • Splenda
  • monk fruit
  • and coconut palm sugar

It’s also important to remember that even if your food is sugar-free, it may still contain a lot of extra calories and carbohydrates which will increase your blood sugar level. Where possible, you should always check the labels on your meals and ingredients to see how many carbs you’re getting.

Top 10 type 1 diabetes food list - The diabetes superfoods

Once you understand how things like carbohydrates, fibre, sugar and starch can impact your blood sugar level, you can plan a diet that works for you and helps you manage your diabetes.

When you’re planning your type 1 diabetes diet it’s a good idea to include these 10 foods, which could be considered ‘diabetes superfoods’:

  • beans
  • dark green leafy vegetables
  • citrus fruit
  • sweet potatoes
  • berries
  • tomatoes
  • fish high in omega-3 fatty acids (like salmon)
  • whole grains
  • nuts
  • fat-free yogurt and milk

Fasting and type 1 diabetes

People fast for many reasons, ranging from religious beliefs to losing weight or detoxing.

If you have type 1 diabetes and intend to fast, it’s important to monitor your blood sugar level regularly. It’s also a good idea to discuss your fasting plan with your doctor.

The challenge with fasting as a type 1 diabetic is that if you’re not eating regularly your blood sugar level may go too low, resulting in hypoglycemia. Mild symptoms of hypoglycemia include hunger, headaches, dizziness, tiredness and shakes. Severe symptoms can include seizures and loss of consciousness.

Fasting for a long time can also cause ‘starvation ketoacidosis’. Starvation ketoacidosis is similar to diabetic ketoacidosis, but slightly different:

  • Diabetic ketoacidosis – happens when you have high amounts of glucose in your bloodstream over a long time and not enough insulin to break it down into energy. Your body will instead start to break down fat to get energy, releasing ketones (fatty acids) into your blood.
  • Starvation ketoacidosis – happens when you have very low amounts of glucose in your bloodstream over a long time. Again, your body will instead break down fat to get energy, releasing ketones into your blood.

Ketoacidosis is a very serious condition, and can cause nausea, vomiting, disorientation, coma and potentially death.

To avoid both hypoglycemia and ketoacidosis, you should break your fast with warm and nutritious foods with a relatively low glycemic index. You should avoid foods that have a high glycemic index, or lots of sugar (e.g. junk food, chips, pasta, white rice, bread, etc.) – This helps you prevent sudden, sharp increases in your blood sugar level, and avoid serious metabolic and digestive issues.

Exercise

Exercise and type 1 diabetes

Following a healthy diet is just one part of building a happy, healthy life with type 1 diabetes. You should also establish an exercise routine, and work out how your exercise and type 1 diabetes can fit together.

A regular exercise routine will help you maintain your weight, stabilise your mood, and improve your sleep patterns. These are just some of the reasons healthcare providers will strongly recommend you exercise regularly.

However, as a type 1 diabetic you will need to monitor your blood sugar level when exercising. A high-intensity workout may cause your blood sugar level to drop, leading to hypoglycemia. Or, intense rounds of exercise may cause your blood sugar levels to increase, causing hyperglycemia – How your body reacts to exercise is very subjective and personal.

To exercise safely as a type 1 diabetic, you should:

  • check your blood sugar level before exercising, and make sure it’s not high or low.
  • monitor your blood sugar level during exercise.
  • track your blood sugar level regularly after exercise – your exercise may not affect your blood sugar level immediately, but could still increase or decrease it for some time after.
  • Check your feet for injuries before and after exercise, and avoid exercises that may cause injury to them.
  • keep snacks and insulin nearby and ready in case you need to adjust your blood sugar level.
  • Exercise in moderation – for good health you should aim for at least 30 minutes every day, and 45-60 minutes if you’re aiming to lose weight.

Types of workouts you should do with type 1 diabetes

Generally speaking, there are four main types of workouts, and as a type 1 diabetic you should not have a problem including any of them in your exercise plan – as long as you monitor and manage your blood sugar level before, during, and after, take care of your body, and workout in moderation.

The four types of workout are:

  • Aerobic: Exercise that increases your heart rate and gets you breathing harder. E.g. Walking, running, hockey, etc.
  • Strength training: Workouts that build muscle mass and strengthen bones and joints. E.g. Resistance training, weight lifting, etc.
  • Flexibility training: Training that stretches your muscles and tendons and increases your range of motion. I.e. Dynamic and static stretches.
  • Balance training: Exercises that focus on stability and maintaining balance. E.g. Yoga and tai chi.

It’s a good idea to mix and match your exercise program, and include all four types of workouts. As a type 1 diabetic, this will help you reach and maintain a healthy weight, reduce stress and lower blood pressure.

Yoga and diabetes type 1

Practising yoga for type 1 diabetes is a good way to improve your diabetic health. This is because yoga is a very versatile exercise option, and can potentially include all four types of workout (aerobic, strength, flexibility and balance).

In particular, yoga includes a lot of stretching, which improves circulation through the muscles and increases blood supply to the body. This is important, because as a type 1 diabetic the insulin you inject to manage the disease needs to get to your body’s cells.

Lifestyle

Sleep and type 1 diabetes

It’s not uncommon for people with type 1 diabetes to have trouble sleeping. This is because both high and low blood glucose levels can interrupt your sleep patterns, making it harder to sleep peacefully.

Here are some tips to help you get a better night’s sleep:

  • Get into a routine – By going to sleep and getting up at the same time every day, you help your body establish a pattern.
  • Be physically active – Being active during the day will help you fall asleep more easily, and also improve your emotional well-being.
  • Avoid caffeine and alcohol, or eating a large meal, before going to bed – If your body is busy digesting, breaking down alcohol, or processing caffeine, it’ll find it harder to switch off.
  • Keep electronics, including computers, TVs and smartphones, out of your bedroom – By making your bedroom a relaxing environment, you’ll find it easier to go to sleep. You’ll also be less tempted to switch on a device if you can’t immediately close your eyes.
  • Don’t forget to take your long-acting, bedtime insulin – Long-acting insulin helps your body maintain a stable background blood sugar level, and will help prevent sleep disturbances. Remember to take it, and don't skip it.
  • If you’re using a continuous glucose monitor, talk to your doctor about setting high and low blood sugar alarms – Waking yourself up may sound counterproductive to improving your sleep, but if you can promptly correct your blood sugar level you have a better chance of going back to sleep and staying asleep.

Travelling with type 1 diabetes

Travelling can be tiring and frustrating at the best of times. The idea of travelling when you also have to deal with type 1 diabetes can be even more off-putting.

However, travel can be a rewarding part of life, and even with type 1 diabetes you can definitely still head off on an adventure.

Here are some tips to help you manage your type 1 diabetes as you travel:

  • Prepare before you go – If you leave everything to the last minute, chances are you’ll leave something important behind or take on too much stress. Take your time, plan ahead, and you’ll be off to a good start on your travels.
  • Stock up on snacks – If your blood sugar level starts to get too low, it’s good to have some snacks on hand to help bring it back up.
  • Consider time zone changes – If you’ve been taking your insulin at set times every day, remember that a change in time zone could disrupt your routine and factor that into your future injections.
  • Buy cooling packs and insulated containers – Insulin can spoil if it’s not kept at an appropriate temperature. It will typically last till its expiry date in the fridge, or up to 28 days at room temperature (15-25 degrees C). Cooling packs and insulated containers can help preserve your insulin if you’re travelling somewhere very hot or very cold.
  • Bring extra medical equipment, such as insulin, test strips, glucose tablets, lancets, etc. – Spare equipment will give you backup options if you lose or damage your current equipment, or if you’re away from home longer than you originally planned. This is particularly important as you may have trouble getting new equipment ‘on the road’.
  • Divide your medical supplies into two, and pack them in separate bags – Separating your equipment can help avoid disaster if one of your bags gets lost.
  • Keep medical supplies in your hand luggage – If you’re flying somewhere, and your blood sugar level starts to go too high or low, you need to have your medical supplies nearby and readily available. If they’re in the plane’s hold, they’ll be hard to access and will limit your ability to take care of yourself.
  • Take a doctor’s letter and a spare copy – Being able to provide documents from your medical provider can make it easier for you to bring your medical supplies through customs.

What now - Live well, and know your low and high sugar level symptoms

Living with type 1 diabetes is a challenge. By comparison, understanding the disease, learning to recognise the symptoms, and figuring out how to treat it is easy.

When you live with type 1 diabetes, it means making an extra 180 decisions a day just to stay healthy. At times, it can feel overwhelming and simply too much to deal with – a sensation referred to as diabetes burnout.

However, it’s definitely possible to live a long, healthy and happy life as a type 1 diabetic. And it starts with:

Diabetes tech is also worth exploring, as you may find something that helps make your life easier – For example, continuous glucose monitors (CGMs) allow diabetics to track their blood glucose levels regularly throughout the day, providing more data (and without the finger pricks).

And it’s a really good idea to reach out and connect with other type 1 diabetics. When you’re part of a community of type 1 diabetics, you’ll have access to a group of people who can:

  • boost your type 1 diabetes knowledge.
  • share everything from recipes to workout plans, travel tips, and diabetes technology insights.
  • lend you an understanding ear.
  • provide advice.
  • and remind you that you’re not alone.

To take the first step connecting with other type 1 diabetics, check out our collection of Your Stories.

And when you’re ready, Share Your Story with us too!

Frequently asked questions - Living with type 1 diabetes

What is the best diet for type 1 diabetes?

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There's no "best" diet for people with type 1 diabetes, as the ideal diet for you will vary based on your individual health goals, lifestyle factors, and personal preferences. Generally though, as a type 1 diabetic, it's a good idea to follow a diet that's low in carbohydrates. That's because your body breaks down carbohydrates into sugar, which is absorbed by your bloodstream. Carbohydrates raise your blood sugar level faster than any other food, and having high blood sugar levels over time can damage your blood vessels and nerves. Following a low-carbohydrate diet can decrease the chance of high blood sugar levels, but you should also make sure your diet is balanced and includes fruits, vegetables, whole grains, lean proteins, and healthy fats.

Can stress raise blood sugar in type 1 diabetes?

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Yes, stress can raise blood sugar levels in people with type 1 diabetes. When your body is stressed, it releases stress hormones like cortisol and adrenaline. These can cause your liver to release stored glucose. This glucose is broken down by your body into sugar, increasing your blood sugar level. To manage your blood sugar level while stressed, you should monitor your level, adjust your insulin as necessary, and practice relaxation techniques. For example, practice deep breathing, meditate, get regular exercise, and make sure you're getting enough sleep.

Can type 1 diabetics donate blood?

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Generally speaking, yes, type 1 diabetics can donate blood, and globally there are many organisations which will accept blood donations from diabetics, as long as their eligibility criteria are met. However, in India, the Ministry of Health and Family Welfare has stated that diabetics can only donate blood if their diabetes is controlled by diet or oral medication. The Ministry has stated diabetics are ineligible if their diabetes is controlled by insulin injections.

Can type 1 diabetics drink coffee?

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Yes, type 1 diabetics can drink coffee. However, coffee may affect your blood sugar level, particularly if you drink it with added sugar or cream. While coffee doesn't contain any carbohydrates, the caffeine may trigger a hormonal response, including the release of adrenaline. Adrenaline causes the liver to release stored glucose, which the body breaks down into sugar, raising your blood sugar level. If you're a type 1 diabetic and drink coffee you should monitor your blood sugar level and limit the amount of sugar or cream you add. It's also a good idea to use low-calorie sweeteners and sugar alternatives.

Can type 1 diabetics take hormone replacement therapy (HRT)?

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Having type 1 diabetes doesn't necessarily mean you can't take hormone replacement therapy (HRT). However, HRT may affect your blood sugar level, and you'll likely need to monitor your blood sugar level more closely. For example, oestrogen-only HRT may improve insulin sensitivity and help with blood glucose control. If you're a type 1 diabetic and considering HRT, you should consult with your doctor. They'll help you determine if HRT is right for you.

Can you join the airforce with type 1 diabetes?

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Unfortunately, people with type 1 diabetes can't join the Indian Air Force or any other branch of the Indian armed forces. This is because type 1 diabetes is considered a disqualifying medical condition, as the potential health complications of the disease could impact a diabetic's ability to perform military duties.

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