Wellness
Developing a strong foundation is critical in helping you successfully and consistently manage type 1 diabetes (T1D).
Transitioning to adult care
Pediatric endocrinologists are experts regarding type 1 diabetes in children, however they may be less familiar with managing T1D throughout adulthood. The transition from your pediatric endocrinologist to an adult endocrinologist can be tricky, and young adults going through this transition may experience trouble managing blood sugar as well as other mental health concerns. It is normal to feel overwhelmed by this transition.
Transitioning to adult care refers to the preparation to move from a pediatric provider to an adult provider. It typically involves:
- A gradual shift of diabetes management responsibilities from parents/guardians to the adolescent/young adult.
- Seeking treatment for psychosocial or mental health challenges that may affect this transition.
- Asking your doctor to send a medical summary to your adult endocrinologist. View an example of information your new doctor will want to receive.
- A referral to an adult endocrinologist by your pediatric endocrinologist.
- Before you transition to an adult endocrinologist, practice taking charge of your endocrinology appointments. For example, you could come prepared with a list of questions you would like your doctor to answer, and when your doctor asks how things are going, try responding before your parent or guardian responds!
- Try to begin the transition process as early as possible. For example, in early adolescence, parents/guardians can gradually begin transitioning diabetes management tasks to the adolescent. At least one year before transferring to adult care, ask your pediatric endocrinologist for an adult endocrinologist referral to ensure no gaps in your care.
- If possible, transfer to an adult primary care provider before you transfer to an adult endocrinologist. It’s best not to transfer to two new doctors at the same time!
- Recognize how adult endocrinology appointments may be different the pediatric visits. There may be less support in-clinic, visits are likely shorter, and your appointments may be more self-directed so don’t be afraid to ask questions!
- You may also need to sign documents to give the practice permission to contact your parents/guardians in the event of an emergency.
Nutrition
- There’s no such thing as a diet all people with type 1 diabetes (T1D) should follow.
- However, the moment you’re diagnosed with T1D, your relationship with food changes. With today’s insulin options and diabetes technology, you have significantly more flexibility in what and when you eat compared to life with T1D years ago.
- Learning about nutrition is a very important part of managing your blood-glucose levels, your insulin doses, and your overall health. Many things you eat or drink affect your blood-glucose levels and insulin needs—some more than others.
- Learning how to count carbohydrates is important in life with T1D because carbohydrates impact your blood-glucose levels the most. Learning how to adjust your insulin doses based on the carbohydrates, fat, and protein in any meal takes time! Work with your healthcare team to understand your body’s insulin needs and develop a plan that works for you.
I was initially hesitant to start meal prepping, as I was under the impression that I would have to eat the same bland, flavorless meal every day in order to maintain my blood sugar and reach my goals in the gym. This is the exact opposite of the truth! There are a myriad of cookbooks, recipes, and social media accounts with healthy, delicious meals and snacks that won’t have a detrimental effect on your blood sugar.”
Mental health
- Living with T1D can be very stressful and lead to feelings of burnout, anxiety, and depression, but you’re not alone!
- Psychologists, social workers, and other clinicians can help equip you to deal with the everyday challenges of living with T1D.
- Consider joining activities that facilitate connection within your local T1D community.
- It’s important to know when to ask for help. Click here for tips on finding a mental health professional!
After being diagnosed with T1D at age 24, so much information was being thrown at me all at once that it was very overwhelming. My mental health was the lowest it had ever been. What helped was educating myself in a way that allowed me to understand what was happening in my body. I also got involved in my local T1D community and take every opportunity to educate others.”
Exercise
- Everyone should strive to engage in daily exercise. Physical activity is great for your body and has positive effects on your mind, too.
- Try to find physical activities you find fun, set realistic goals, and don’t try to do too much too quickly!
- Check blood glucose before and after exercising, and keep snacks on hand during a workout.
- Consult a doctor or Certified Diabetes Care and Education Specialist (CDCES) about adjusting insulin levels around your exercise routine and keep them updated on any changes to your fitness regimen.
- Continue to check blood glucose after exercising, as levels can be affected for up to 24 hours.
- Managing T1D during and after exercise starts with learning how your glucose levels respond to exercise of different types. By learning more about basic exercise science and the timing of your insulin vs. food and physical activity, you can exercise more safely and reach your fitness goals.
- Work with your healthcare team to find the best exercise regimen for you.
Drinking responsibly
- Just like people without T1D, it is best to drink in moderation.
- Some types of alcohol, like beer, sweeter wines, sweetened mixed drinks, and hard cider, contain a significant amount of carbohydrates all on their own. Straight liquor usually contains zero carbohydrates, but it’s often mixed with very sweet fruit juices, soda, or additives if it’s flavored. This means you may need more insulin for certain alcoholic drinks over others. Approach every drink carefully and research the carbohydrate content, just as you would if it were food, to help you estimate insulin doses.
- Drinking can cause delayed hypoglycemia (low blood sugar) even hours after you drink. Your body sees alcohol (or ethanol) as a toxin, which means your liver wants to process it and remove it from your body as quickly as possible. Your liver will stop its other usual functions—like releasing small amounts of glucose every hour—while it’s focused on processing the alcohol you drank. This increases your risk of hypoglycemia, and activity, such as dancing, combined with drinking alcohol, can further increase your risk of severe hypoglycemia.
- Emergency glucagon is a treatment for severe hypoglycemia that tells your liver to release a large amount of stored glucose. If you’ve consumed a large amount of alcohol, emergency glucagon treatments may not be as effective because your liver is focused on removing alcohol from your body. It won’t respond to the glucagon as fully as it would if there were no alcohol in your system.
- Drinking alcohol excessively in a short amount of time increases your risk for hypoglycemia. Keep carbs on hand while you are drinking and eat some while / after you are drinking. It is recommended not to include the carbohydrate content of the alcoholic drink in your carb-counting calculations.
- Closely monitor your glucose levels before you go to sleep and the next day, as alcohol can cause your blood sugar to drop hours after consumption.
T1D Resource Library
What you need to know about navigating life with type 1 diabetes, including insurance, school, relationships, pregnancy, and more.
