Newly diagnosed – things to help

Managing diabetes can be difficult at times, but you can still do the things you enjoy. This guide should help you get started.

How to check your blood glucose levels

Checking your blood glucose is quick and easy, although it can be hard to get used to at first.

You should have been given:

• a blood glucose meter
• small needles called lancets for pricking your finger
• a lancet device (finger picker) to hold the lancets
• a 'sharps bin' for throwing away used needles
• test strips

To check your blood glucose:

1. Wash your hands.
2. Put a test strip into the blood glucose meter.
3. Attach a lancet to the finger picker - use a fresh lancet every time.
4. Place the finger picker to push the lancet in.
5. Press the button on the finger picker to push the lancet in.
6. Gently squeeze your finger until you have a drop of blood.
7. Hold your finger so the blood touches the top of the test strip.
8. Read the numbers on the screen of your meter.

When to check blood glucose levels

Try to check your blood glucose:

• on waking up
• before meals
• before bed
• before, during and after exercise - take a break during exercise to check you levels
• before driving or operating machinery
• if you feel unwell or like your blood glucose levels are high or low
• if you have been drinking alcohol

This helps you understand your blood glucose levels and how they're affected by meals and exercise. It should help you to manage your diabetes.

Blood glucose – the numbers

Your diabetes team should have discussed with you the blood glucose levels to aim for.

There's a range of ideal glucose levels that are used as a guide. Do not worry if your numbers are different - this is just a guide. Aim for the levels agreed with your team.

The ideal range for blood glucose levels are:

• on waking up or before breakfast: 5 to 7mmol/L
• before other meals: 4 to 7mmol/L
• before bed: 5 to 9mmol/L

Your blood glucose levels can be affected by all sorts of things, including:

• what you eat and drink
• stress
• illness or infection
• some medicines
• being more or less active than usual
• pain
• periods
• drinking alcohol

Learn more about your blood glucose numbers - jdrf.org.uk

How to inject insulin

Injecting insulin should not hurt, the needles are very small.

You should have been given:

• insulin pen
• needles

Where to inject:

• your tummy
• your outer thighs
• your buttocks

How to inject:

1. Make sure your hands and the area you're injecting are clean.
2. Attach a new needle to the pen.
3. If it's a reusable pen, insert insulin cartridge if needed.
4. You need to do a test shot into the air each time before using the pen to.
5. Set the correct dose for testing- 8 units if it's a new pen or 2 units for routine test shots.
6. Squirt this insulin into the air to make sure there are no air bubbles.
7. Set the correct dose of insulin your team recommended for this time of day.
8. Put the needle into your skin quickly at a 90 degree angle- at least an inch from where you last injected - keep away from your belly button or any scar tissue.
9. Inject the insulin by pressing the button down, count to 10 before removing the needle from your skin.

Recognizing and treating hypoglycaemia

Hypoglycaemia (a hypo) happens when your blood glucose level is too low, (below 4mmol/L).

Causes of hypos include:

• not eating enough carbohydrates at your last meal
• eating meals later than expected
• taking too much insulin
• unplanned or extra activity
• drinking large amounts of alcohol

The most common symptoms are:

• sweating
• being anxious or irritable
• feeling hungry
• difficulty concentrating
• blurred sight
• trembling and feeling shaky
• people may notice that you look unwell, confused or have a change of mood

Treating a hypo

You need to treat a hypo quickly, before it gets worse. Eat or drink something sugary (15 grams fast acting glucose or sugar).

Take one of these types of sugar to treat your hypo:

• 5 dextrose or glucose sweets
• 3 to 4 jelly babies
• 1 small glass (150mls) regular sugar drink, for example, a mini can of cola
• 1 glass or small carton of fruit juice ( 200mls)

Try not to take too much of:

• fast-acting sugar - this will make your blood glucose go too high
• sugary foods with a lot of fat like chocolate, cakes and biscuits - these work too slowly for treating a hypo

After 10 minutes:

1. Recheck your blood glucose.
2. If still under 4mmol/L repeat the hypo treatment.
3. If over 4mmol/L and your next meal is not due soon, have a snack like a piece of fruit or slice of bread.

Find out more about hypos

Check you're safe to drive

Legally, if you have diabetes and you drive you need to:

• check your blood glucose is above 5mmol/L before driving
• check your blood glucose every 2 hours if you're on a long journey
• carry a glucose meter, hypo treatment and carbohydrate snacks like a cereal bar or banana when driving

If you feel your levels are low:

1. Stop the car when it's safe.
2. Remove the keys from the ignition.
3. Get out of the driver's seat.
4. Check your blood glucose and if low treat your hypo.
5. Do not drive until 45 minutes after your blood glucose has returned to above 5mmol/L and you feel well.

There is more information on driving when you have diabetes in the NDLS booklet Diabetes and driving (PDF, 584 KB, 8 pages)

Check-ups and appointments

You should expect regular regular appointments with your hospital diabetes team once you have a diagnosis of type 1 Diabetes. If you have any concerns about your diabetes, contact your diabetes team.

Regular check-ups

These should be every 6 months and more often when you are newly diagnosed.

Diabetes check-up

This is a meeting with your care team to see how you are managing diabetes in your day to day life. You can discuss issues or concerns you may have and plan for supporting your care going forward.

Your care team will do some checks including:

• your blood glucose levels for the past 8 to 12 weeks - HbA1c test
• your blood cholesterol
• blood and urine tests to check your kidneys are working okay (kidney function)
• your weight
• your blood pressure

The check-up is also a chance for you to discuss your blood glucose readings together.

Once a year

Eye screening

You'll be invited for eye screening. This is also called retina screening. A photo is taken of the back of your eye. This checks for any changes to the blood vessels in your eyes caused by diabetes. It's different from a sight test and does not check if you need glasses.

The Diabetic RetinaScreen programme offers yearly free, diabetic retinopathy screening to people with diabetes aged 12 years and older.

If you have diabetes and would like to check you are on our register, call freephone: 800 45 45 55 and choose option 1.

Diabetic retina screening