Type 1 Diabetes

Insulin is a hormone needed for cells to absorb sugar from the blood. In type 1 diabetes, the body has stopped producing insulin and you get too much sugar in the blood. Signs of type 1 diabetes include being tired and powerless, losing weight quickly, kissing more often and being very thirsty. Diabetes is a disease you have throughout your life, but there is a good treatment to be had.

Diabetes is a collective name for some diseases that all-cause too much sugar in the blood. In addition to type 1 diabetes, there is type 2 diabetes and pregnancy diabetes. Type 1 diabetes is a partially hereditary disease and usually develops when you are a child or in your teens.

Symptoms of Type 1 Diabetes

Common signs of type 1 diabetes are that you:

  • need to pee often and much
  • gets very thirsty
  • feeling unusually tired and powerless
  • feel sick
  • has stomach ache
  • smells of acetone from the mouth
  • looks blurred and gets visual disturbances
  • quickly lose weight.

other Symptoms of Type 1 Diabetes may be that you get fungal infections in the abdomen or mouth.

The symptoms of type 1 diabetes usually develop over a few to a few months. When the symptoms come slowly they can be difficult to notice. In one in three people who develop the disease, the development takes place over a long period of time and can at first be misinterpreted as type 2 diabetes.

If the body does not receive insulin for several days, there is a risk that blood sugar levels will be very high. It can cause you to have difficulty breathing, become dumbfounded or even unconscious. Often your breath smells of acetone. You may then have received acid poisoning, called ketoacidosis. It is an acute condition that can be life-threatening, but it is unusual because you usually feel so bad that you seek treatment for your symptoms earlier.

When and where should I seek care?

If you think you have type 1 diabetes, contact a health care center or an on-call clinic immediately. If closed, seek care at an emergency room.

Investigations

Both blood and urine tests are used to determine if you have type 1 diabetes.

Blood tests

To examine the blood sugar value

With a blood test called P-glucose, the doctor can see the blood sugar level at the time of sampling. Usually a small stick in the finger is enough. P stands for plasma and is part of the blood. Glucose is another name for sugar.

The long-term sugar test, HbA1c, shows how blood sugar levels have averaged over the past two to three months. A high value indicates that the average blood sugar level has been high for two to three months prior to sampling.

To test antibodies

In type 1 diabetes, the body forms antibodies against the cells of the pancreas that produce insulin. A blood test allows the doctor to see if you have such antibodies. This indicates that you have type 1 diabetes, and not type 2 diabetes.

The antibodies that the doctor usually looks for are so-called GAD antibodies and IA-2 antibodies. The insulin production remaining in the body can be measured with the blood-tested C-peptide.

After the investigations

You should find out who you should contact, and when, to find out the answers after sampling and surveys. You should also find out who to contact if you get worse.

Treatment for type 1 diabetes

Diabetes is a chronic disease, that is, a disease you have throughout your life, but there is a good treatment that can be adapted to your habits and routines. The treatment consists of taking insulin. In this way, the cells can absorb the sugar contained in the blood and the blood sugar value is kept at a good level.

You need to take insulin for the rest of your life. It is important to get started on treatment as soon as possible and to try to keep a blood sugar value close to that of people without diabetes.

In the short term, the goal of treatment is to avoid acute symptoms that occur at too high or too low blood sugar levels. The long-term goal is to prevent complications, such as damage to small and large blood vessels.

Insulin pens or insulin pump

Insulin does not exist as tablets but must be injected into the subcutaneous tissue, usually on the stomach or thigh, with syringes or with the aid of an insulin pump. The syringes usually look like pens and are therefore called insulin pens:

  • Disposable pens are filled with a certain amount of insulin and are discarded when they run out.
  • Insulin pens that you load with ampoules containing insulin. The ampoules are replaced when empty.

Insulin pumps are small insulin containers that dispense insulin to the body in small doses, around the clock. With an insulin pump you do not need to stab yourself every time you need insulin.

The dosage of the insulin pump is controlled by a schedule that you can program into the pump. If you need more or less insulin, you can increase or decrease the dose.

There are two variants of insulin pumps:

  • One that you can wear in a belt without being visible on the clothes. The pump is connected via a thin plastic tube, a so-called catheter, to a needle that you have under your skin on your stomach.
  • One in the form of a small capsule that is pressed into the subcutaneous fat with a thin needle. It is usually placed on the outside of the upper arm. The pump is controlled wirelessly through remote control.

Dosage and choice of insulin

There are many different types of insulin. They differ in how fast the effect comes after injection and how long the effect lasts. The different types of insulin allow you to receive a treatment that is completely tailored to your needs and habits.

The doses of insulin needed vary from person to person. The need for insulin depends on the blood sugar levels, which in turn depends on how much you exercise, what you eat and how much you eat. Eventually, you will learn how blood sugar levels react to different types of activities and to different types of food and be able to adjust your insulin dose accordingly.

At the beginning of treatment, you need to go through the different types of insulin and doses with your doctor and diabetes nurse. It is important that you determine which insulin doses and how many injections per day you need and which fit your daily routines. That the treatment works well is a prerequisite for you to be able to keep your blood sugar value as well as possible.

When discussing treatment, it is good to try to get answers to the following questions:

  • are the role do you want in the treatment yourself?
  • What support do you need from the diabetes team?
  • What do your days look like and how do you want to live your daily life?

Check your blood sugar levels

An important part of the treatment is to have control over the blood sugar value. The blood sugar value is the measure of how much sugar you have in your blood. It is indicated by mmol / l, an abbreviation for millimole per liter. A person who does not have diabetes has a blood sugar value of 4-5 mmol / l in the morning before breakfast and a value of 5-7 mmol / l one to two hours after a meal.

Blood sugar value is affected by food and physical activity

Blood sugar levels increase as you eat and fall in conjunction with physical activity. The value also depends on what and how much you have eaten, and how intensely you have exercised. Ideally, the blood sugar level should not rise above 9 mmol / l after a meal, but it is more important to see how the average blood sugar value has been for an extended period of weeks and months. This is done with a blood test called HbA1c, sometimes also called long-term sugar or long-term sugar test.

How to measure with a measuring stick and blood sugar meter

You measure your blood sugar value yourself:

  1. Insert a dipstick into a blood glucose meter.
  2. Make a small stick on your fingertip to form a drop of blood.
  3. Hold the dipstick against the drop so that the blood is sucked into the stick.
  4. After a short while, you can read the blood sugar value.

There are several different blood glucose meters and measuring sticks that you can use. The blood glucose meters can be purchased at a pharmacy or from a diabetes nurse. The measuring sticks are free of charge. They are printed on so-called aid cards by a doctor or diabetes nurse and collected at a pharmacy. In some county councils, you get the meters and sticks at your health center. For visually impaired people there are talking blood glucose meters.

Sensors are constantly measuring

It is increasingly common to have a small sensor that continuously measures the blood sugar value in the subcutaneous fat. You attach the sensor to the subcutaneous fat yourself. You can read the blood sugar value on a small monitor, on a mobile phone or in an insulin pump connected to the sensor. 

There are sensors that can alert if the blood sugar value becomes low. 

There are also sensors that are connected to an insulin pump. These types of sensors can activate the insulin pump. Then the pump can supply more or less insulin, depending on the blood sugar level.

Diabetesdagbok

It will take some time before you learn how to dose your insulin to keep your blood sugar at a good level. In the beginning, you get to test yourself by often measuring your blood sugar value. Write your values ​​in a diary or download the values ​​from your meter to special programs on your computer. This way, you can see how blood sugar levels vary in different situations and over the clock, and it can be easier to understand how they are affected by insulin doses, food, drink, and physical activity. These are examples of what you can note:

  • Your blood sugar level before a meal and an hour and a half afterward, to see how different types of food affect blood sugar.
  • What and how much you have eaten.
  • How much insulin you have taken.
  • Your blood sugar level before and after exercise, to see how exercise lowers the value.
  • What kind of exercise you did.
  • What blood sugar value you have before you go to bed for the night.

Regular contact with the diabetes team

If you have type 1 diabetes, you will be followed up and checked at a diabetes clinic at the hospital. There are so-called diabetes teams with healthcare professionals who have specialized knowledge of the disease. A team always includes a doctor in charge of the treatment and a diabetes nurse who shows, among other things, how to take your insulin and blood sugar tests. Often, the team also has access to people from other professions:

  • A psychologist you can talk to.
  • A dietician who tells how food affects blood sugar and gives advice on food issues.
  • A curator who answers questions about financial and social support.
  • A physiotherapist.
  • A foot therapist.

It is important that you have regular contact with the team. Together you design the treatment that suits you best. The team helps you understand your illness and how you can affect it yourself, but they also provide support and encouragement as well as advice on how to deal with different situations in everyday life.

You will primarily have regular contact with the doctor and the diabetes nurse, initially several times a year. You can meet the others on the team if needed. How often you have a return visit to the diabetes team changes over time.

At the return visits, the doctor looks at how the treatment works

By taking blood and urine tests, the doctor can see, among other things, how blood sugar levels have been around for the past two to three months and how the kidneys work. Your doctor or diabetes nurse will also examine the skin where you take your insulin. You will have your blood pressure and your blood fat checked once a year.

You will talk about the following:

  • How the treatment works and how to take the syringes.
  • About your eating habits.
  • About physical activity.
  • If you are taking other medicines.
  • About any smoking habits.

Important to understand

In order to be active in your care and to make decisions, it is important that you understand the information you receive from the healthcare personnel. Ask questions if you don’t understand. You can also ask to have the information printed to read it peacefully.

If you do not speak English, you have the right to get information in your own language, for example with the help of a language interpreter. You may also have the right to receive interpreting assistance in the event of hearing loss.

What can I do for myself?

Eat regularly

Good food in diabetes is no different than good food for everyone. Depending on what you usually eat, you may need to change your eating habits by both reducing the total amount of calories and spreading them on more targets.

It is good to eat regularly and try to distribute the meals as evenly as possible throughout the day. If you are going to eat sweets you should preferably have eaten food before.

Exercise

Exercise lowers blood sugar levels, as a physical activity allows muscle cells to absorb sugar from the blood to some extent without insulin.

The blood sugar value is lowered after about 20 minutes of physical activity and is usually stabilized after about half an hour, as the blood gets new sugar from the sugar stores in the liver. As long as you exercise or work out physically, the sugar stores in your liver are depleted.

When you have finished exercising, your blood sugar value will be at a relatively low level. The blood sugar lowering effect can last for several hours after the workout. This is because the sugar in the blood replenishes the sugar stores in the liver that were emptied during exercise. Lowering blood sugar levels can sometimes be so severe that you get an insulin sensation.

When you exercise

It may take time to learn how physical activity lowers blood sugar levels and thus the need for insulin, both at the time of exercise and afterward. The reduction depends, among other things, on how intensely you exercise, and how long.

Measure your blood sugar value before and after a workout to see if you need to reduce your insulin dose, and if so, how much. You may need to reduce your insulin dose by up to half before a workout to avoid getting too low blood sugar. If you are exercising intensively, you must reduce the dose even more.

If you exercise in the evening, you may need to reduce the dose of evening insulin so as not to have blood sugar drops during the night. If you have an insulin pump, you may need to reduce your basal dose for a number of hours. You may also need to reduce the amount of insulin you take before a meal.

Before, during and after the workout, you may need to eat extra carbohydrates, such as fruit. If you exercise for more than half an hour, you should take extra carbohydrates every half hour as long as you exercise. Grape sugar, juice or chocolate usually work well.

Drink moderate amounts of alcohol

It is possible to drink wine or beer for food. But you should not drink alcohol unless you are eating something or drinking too much at the same time. If you have any questions, you can talk to your doctor or diabetes nurse.

If you get intoxicated, it is very important that you eat something before you fall asleep. For example, it can be a sandwich and a glass of milk. You should also reduce the amount of long-acting insulin you take at night. Otherwise, you may have a blood sugar drop during the night and in the worst case become unconscious. The intoxication also makes it harder for you to perceive your body’s warning signals at a low blood sugar value.

The blood sugar drop is because the liver gets busy breaking down the alcohol in the body and is unable to simultaneously add new sugar to the blood.

Avoid smoking

If you have diabetes and smoke, it is very good to quit, as smoking increases the risk of most complications that can occur in diabetes, for example:

  • The risk of heart attack increases three to five times if you have diabetes and smoke than if you do not smoke and do not have diabetes.
  • The risk of getting fat in the large blood vessels of the bones increases. The fatness impairs blood circulation in the legs and in the long term it can lead to vasoconstriction in the legs, so-called window titer disease.
  • Hard-to-heal wounds on the legs and feet, as a result of impaired blood circulation in the legs.
  • Increased risk of kidney damage that can lead to dialysis or kidney transplantation.
  • The risk of stroke is greater if you have diabetes, smoking further increases the risk.

It is unclear if snuff increases the risk of complications in diabetes.

Shot the feet

Diabetes can impair the sensation and blood circulation in your feet, so it is important that you take care of your feet. For example, it is good if you do the following:

  • Wear clean socks and good shoes that are not too tight. Signs that the shoes are too tight may be that the skin on the feet becomes red, that there is a hardening or onset of wounds.
  • Regularly check that you have not received any hardening or abrasions.
  • Feel free to lubricate your feet with softening cream to avoid dry cracks. It is especially important during the winter when it is easier to get dry cracks.

If you have reduced feeling in your feet, it is extra important to take care of your feet. The Impaired sensation is due to impaired nerve function, which can also cause the skin to not moisturize normally. Your feet then become dry and you can get cracks in your skin that can develop into wounds.

Because diabetes impairs blood circulation, wounds can be infected more easily. impaired blood circulation also allows wounds to heal more slowly. Take care of the wounds that occur, and pay attention if they heal slowly or become infected. Then you should contact your diabetes team.

Check your eyes

You should have your eyes examined regularly with so-called eye photography. This is because a blood sugar value that is too high for a long time can damage the small blood vessels in the retina of the eye. In the long run, it can cause vision to deteriorate.

With eye photography, the doctor can detect early changes in the retina that you yourself do not notice. You can then receive treatment on time and prevent vision from deteriorating.

How often you should examine your eyes with eye photography depends, among other things, on how long you have had diabetes. It is usually one to three years between surveys. The diabetic or eye reception will send a notice to you when it is time to examine.

Shot the teeth

You should visit a dentist or dental hygienist regularly. The reason is that an elevated blood sugar value for a long time can make it easier to get tooth decay or tooth decay. Inflammation of the gums can also raise blood sugar levels.

Tell your dentist or dental hygienist that you have diabetes. They can then give you information on how to care for your teeth and what to think about.

You may be entitled to a special dental allowance, STB. The dental allowance means that you do not have to pay the full price for a dentist visit.

What happens in the body?

The cells in the body need the energy to function. The energy is transported in the blood mainly in the form of grape sugar and in order for the cells to absorb the sugar they need the hormone insulin. The blood sugar that is not absorbed by the cells is stored in the liver and in the muscles for later needs. The stored blood sugar in the liver is called glycogen. The liver functions in this way as a sugar supply.

Insulin is formed in the pancreas into small groups of hormone-forming cells called Langerhans islands or beta cells. The insulin is released at low concentrations all the time, but especially after eating. In type 1 diabetes, the body’s own immune system has attacked the cells in the pancreas and destroyed them so that they can no longer produce insulin. When there is no insulin, the body’s cells cannot take in the blood sugar, but it stays in the blood and the blood sugar level rises.

Ketones are formed

When the cells get no energy from the blood sugar, they burn the body fat instead. If the cells burn a lot of fat, it forms a type of acids called ketones. Too much ketones can damage the body and lead to ketoacidosis. It can also occur if you completely stop taking insulin, something you should never do.

Different forms of diabetes

Diabetes is a collective name for several diseases that all cause too much sugar in the blood of the person who got the disease. In the past, diabetes was called diabetes because blood sugar levels are elevated. The reason why the blood sugar level is too high differs between the different diseases:

  • In type 1 diabetes, the body has stopped producing insulin.
  • Type 2 diabetes is due to the fact that the cells’ sensitivity to insulin has decreased and that the body’s insulin production has subsequently decreased. This form of diabetes was formerly called age diabetes.
  • Pregnant diabetes is a form of type 2 diabetes that pregnant women can get. After childbirth, blood sugar levels usually return to normal.
  • LADA, Latent Autoimmune Diabetes of the Adult, is a form of type 1 diabetes that middle-aged and older people get. Sickness is slower and with fewer symptoms.

What is the cause of type 1 diabetes?

Type 1 diabetes is partly a hereditary disease. It inherits a tendency to develop an immune system that can attack and destroy the cells that makeup insulin. It is unclear why the immune system attacks the cells.

Acute complications

Acute complications in diabetes are due to blood sugar levels being too high or too low.

Ketoacidosis if blood sugar is too high

If your blood sugar level rises and becomes very high and you have insulin deficiency at the same time, you may get ketoacidosis. It is an acute and life-threatening condition.

The first signs are the usual diabetes symptoms, for example, that you need to urinate often and become thirsty. If your blood sugar does not go down, you will get more symptoms within a few hours:

  • Nausea.
  • Vomiting.
  • Headache.
  • Stomach ache.
  • That it smells of acetone from the mouth.
  • That you become dumb and possibly unconscious.
  • Difficulty breathing.

Check your blood sugar value if you have any of the above symptoms. If you have high blood sugar levels and symptoms of ketoacidosis, you should contact your diabetes clinic as soon as possible. If it is closed, you should seek care at an emergency room.

The symptoms can come both fairly quickly or for a longer period, from hours up to several days. Ketoacidosis can develop if the blood sugar value is above about 15 mmol / l. 

If you are pregnant, you may get ketoacidosis at lower blood sugar levels.

The most common cause of ketoacidosis is stomach upset with vomiting and diarrhea. This is because many people then stop taking their insulin. You may also get ketoacidosis for other reasons:

  • That you have a fever or an infectious disease that increases blood sugar levels and thus the need for insulin.
  • That you have not taken enough insulin for a while.
  • That there is a stop in the insulin supply, if you have an insulin pump.

Insulin sensation – too low blood sugar

If your blood sugar level drops sharply, you may get a so-called insulin sensation, also called hypoglycemia. Insulin sensation is a serious condition and usually occurs if the blood sugar value becomes less than 3-4 mmol / l, but it can differ between people.

The following symptoms are common in insulin sensation:

  • You get sweating.
  • You get hungry.
  • You tremble or shake.
  • You get worried.
  • You become unconcentrated and easily irritated.
  • You get palpitations.

It can be different fast to get insulin feelings and the symptoms can be different strong. If you do not get sugar in any form, you may become numb and lose consciousness.

It is important that you raise your blood sugar level:

  • Start eating something that raises blood sugar quickly, such as grape sugar. Take one to two tablets per 20 kilos of body weight.
  • Rest for a while.
  • After 10-15 minutes, blood sugar has risen 1-3 mmol / l. Then you should eat something, such as a fruit, a sandwich or drink half a glass of milk.

How much to eat depends on your weight, how physically active you will be afterward and when you eat the next meal.

There are disposable syringes with the hormone glucagon which raises the blood sugar value you can have at home. The glucagon is injected under the skin or into a muscle. You can take a glucagon syringe yourself, or it can be given by a person who has been instructed how to do it. The person does not need to be trained in health care. Glucose syringes are good to carry with you for example mountain trips, long boat trips or trips abroad.

If you cannot get grape sugar in you or if you become unconscious, the blood sugar value can be increased by receiving an injection of sugar solution directly into a blood vessel. This is done by healthcare personnel, such as ambulance staff. If you receive an injection with a sugar solution, you do not need to go to an emergency room.

After an insulin sensation, you can have a so-called recoil effect for the next 24 hours. This means that the blood sugar value becomes too high.

The reason you get an insulin sensation may be one of the following:

  • You have been given too much insulin.
  • You have not eaten properly after an insulin injection.
  • You’ve been drinking alcohol.
  • You have exercised a lot and intensely. 

If you do not understand why you have an insulin sensation, you should discuss it with your diabetes nurse.

It is important that family, friends and work colleagues know that you have diabetes and what to do if you get an insulin sensation. In the first place, you may need help eating something that quickly raises blood sugar levels, but you may also need help from ambulance staff or coming to a hospital.

If you get sick

You may need to change your insulin dose when you get sick. Depending on what the disease is, you either need to increase or decrease your insulin dose. Therefore, it is important that you test your blood sugar frequently.

In an infection, such as a cold or urinary tract infection, you may need to increase your insulin dose. If you have a fever, it is extra important to increase your insulin dose.

If you get stomach upset with diarrhea and vomiting, you may need less insulin as it may be difficult to get enough food. But the body’s reaction to stomach ailment can also cause blood sugar levels to rise. If you find it difficult to get in or to keep food and drink, you can try to drink small amounts of fluid replacement often.

Never stop using your insulin

No matter how little you eat or if you vomit food, you should never completely stop taking insulin. Instead, you should measure your blood sugar frequently often and reduce your doses of insulin depending on your blood sugar value. If you are unsure of how to do it and if the symptoms last for more than a day, contact your health care provider.

Always check your blood sugar level if you are vomiting, as there may also be signs of high blood sugar and you are getting ketoacidosis. 

Long-term complications

In the long term, a high blood sugar value is detrimental to the body’s blood vessels. Both the small so-called capillaries and the larger blood vessels can be damaged. An early sign that blood vessels have started to damage is that protein, called egg white, leaks into the urine via the kidneys.

Blood vessel damage can lead to: 

  • Reduced vision
  • impaired renal function, so-called renal failure
  • impaired blood circulation and decreased sensation, mainly in the feet
  • myocardial infarction
  • stroke
  • angina

Keeping the blood sugar level at the best possible level can reduce the risk of damage to the blood vessels. A good blood sugar value is close to what people without diabetes have.

Myocardial infarction, stroke and angina pectoris are due to damage to the large blood vessels. To prevent myocardial infarction and stroke, it is even more important to have normal blood pressure and a low cholesterol value than to have a good blood sugar value. Over time, therefore, you may also receive treatment with medicines for high blood pressure and medicines for high blood fats.

Reduced vision

The damage that occurs to the eye can be difficult to detect, as the damage to the retina’s blood vessels can develop for a long time without affecting vision. Regular eye photography allows the ophthalmologist to detect small damage to the retina’s blood vessels that do not yet produce symptoms.

The visual impairment that is common in connection with diabetes diagnosis is over. It is caused by the lens of the eye swelling by the high blood sugar value. The eye cannot then set the sharpness properly and it causes you to look blurred. This goes on after a few weeks when blood sugar levels improve.

Renal impairment

When the kidneys’ small blood vessels are damaged, it can cause the protein to leak into the urine. In the beginning, these are very small amounts of protein, often called microalbuminuria. The damage can heal if the blood sugar value becomes good and the blood pressure is lowered.

The amount of protein in the urine increases if the damage worsens. At the same time, the kidney’s ability to purify the blood from waste products is reduced. If it continues, a condition called kidney failure will arise  . If you have protein in your urine you should be careful to keep your blood sugar level at a good level.

If you have protein in your urine, you may be treated with certain types of blood pressure medication, although your blood pressure is normal. If you also have high blood pressure, it is important to lower and keep this as good as possible, ie at below 140/85 mmHg. Sometimes the goal may be a blood pressure below 130/80.

Feeling worse in the feet

The feeling deteriorates when the thin blood vessels to different nerves are damaged, but a high blood sugar value also directly damages the nerves. Usually, nerve damage, called polyneuropathy, occurs in the feet. It can lead to numbness and you do not know if you get shoe polish or sores on your feet.

Sexual problems associated with diabetes

Blood circulation and nerves in the genitals can also be affected by damage to the blood vessels. This means that men find it difficult to obtain and maintain positions. There are several different types of medicines that improve the ability to get a hold.

Women can have problems with reduced sensation, which can lead to difficulty getting orgasm. Another problem may be dry mucous membranes and difficulties for the vagina to become sufficiently moist. Lubricants available at pharmacies can be a good tool.

Lighter holes in the teeth

An elevated blood sugar value over a long period of time can make it easier to get tooth decay and tooth decay . Inflammation of the teeth or gums can, in turn, lead to increased blood sugar levels. It is therefore good to take care of the teeth carefully and go to the dentist regularly.

You may be entitled to a special dental allowance, STB. The dental allowance means that you do not have to pay the full price for a dentist visit.

Gastrointestinal problems

In diabetes, you may also have stomach and intestinal problems, for example, the stomach may be more difficult to empty into the gut as it should. This can make it more difficult to regulate blood sugar levels. You can label it by the following example:

  • You can get measured quickly.
  • May you feel ill after eating.
  • You may have low blood sugar levels even though you have eaten.

Talk to your doctor if you suspect you have gastrointestinal problems. 

Pregnancy and type 1 diabetes

It is important to keep your blood sugar level at the best possible level if you are planning to become pregnant, both during conception and throughout pregnancy. It reduces the risk that the fetus is affected by the mother’s diabetes.

If you have diabetes and are planning to become pregnant, it is also important to take dietary supplements with folic acid as soon as pregnancy is planned. Folic acid is a vitamin B needed for cell division in the body. 

If you become pregnant, you should contact your diabetes clinic as soon as possible to review your treatment. The reason is that the need for insulin increases during pregnancy as the fetus grows. You should also have frequent return visits. Most often, the control of pregnant women with diabetes takes place in close cooperation between diabetes nurse, diabetes doctor, obstetrician and midwife.

Living with type 1 diabetes

It is possible to live a good and active life with diabetes, although it may take time to get used to and accept the disease. You will receive insulin treatment that is tailored to your needs and habits, making it easier to have good control over your blood sugar value. You will also learn what affects blood sugar levels, and how you react when you have too high or too low a value.

The diabetes team can support you and give you advice when it feels difficult. Ask them if, for example, you do not know how to dose your insulin in different situations, or how certain foods affect blood sugar levels. But even if you can get support and encouragement from the team, you have to take the greatest responsibility for the treatment yourself. The result depends largely on how you manage your diabetes.

It can be helpful to meet others who have similar experiences. In many parts of the country, there are local diabetes associations where you can get support. There are also books that describe what it is like to live with diabetes.

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