Diabetes type 1

Everyday factors that affect diabetes control

Controlling diabetes involves thinking about all the factors that impact on blood glucose, including the carbohydrate you eat, and the amount of insulin you need for it, the exercise you have recently done and the exercise you are planning to do, and learning how your body reponds to different circumstances.  

In addition to everyday practical issues which young people talked to us about, which were not always straightforward in their lives such as leaving home, cooking their own meals and going out with friends, they also talked to us about other things that affected blood glucose levels. Those who felt they had reached a good understanding of what to do and when to do it said they gradually accepted they needed to think ahead and plan their lives, but that once they had done so, they got better. But others said they found forward thinking and planning about everyday matters was difficult and that they needed support and help. 

Exercise and insulin control
Exercise brings down blood glucose levels and those who play sport have to learn the particular ways different kinds of exercise affect their insulin and carbohydrate balance. Some found that it took quite a while for them to work out the amount of insulin that suited them, particularly those who played energetic games like football or rugby. Several suggested that a good way to manage blood glucose levels when exercising is to start with higher levels than usual so as to avoid having a hypo.

Getting control over blood glucose levels long-term
The young people we talked to were clear that they needed to have "good" HbA1c test results. (HbA1c means glycated haemoglobin.) An HbA1c test measures average blood glucose over several weeks. 

Most young people defined 'good control' as having HbA1c levels between 6 and 7 per cent (42-52 mmol/mol). Levels around 8 or 8.5 per cent (64-69 mmol/mol) was seen as doing 'all right', and most people said that anything above 9 (75 mmol/m was 'bad control'. Very few young people said they had been able to maintain "good" HbA1c results over several years. National data suggests that it is hard for everyone with Type 1 to hit these targets. According to the National Diabetes Audit 2014, nearly three quarters of people with Type 1 diabetes in the UK have an HbA1c above 7.5 per cent (58mmol/mol).

HbA1c results are currently given as a percentage e.g. 6.5 per cent, but from 31 May 2011 in the UK, HbA1c will be given in millimoles per mol (mmol/mol) instead of as a percentage (%).

To help make this transition as easy as possible, all HbA1c results in the UK will be given in both percentage and mmol/mol from 1 June 2009 until 31 May 2011. 

Avoiding fluctuations in levels
The majority of the young people we talked to said that they have gone through 'good and bad patches' and that it was not always possible to maintain stable blood glucose levels. Some people preferred to not think about controlling their diabetes in too much detail in case they got 'obsessed' by the illness, and many felt they could afford to be relaxed about fluctuating levels at this point in their lives and that eventually levels would stabilise.

Periods and hormones
For women the monthly menstrual cycle and periods can cause blood glucose to change. Many young women said that their blood glucose levels tend to fluctuate between low and high before and after their periods.

External factors that can affect diabetes
Everyday illnesses such as colds, flu, tummy bugs can affect glucose levels especially if you lose your appetite and stop eating normally. Young people said that having regular sips from drinks such as lucozade and eating toast had helped them. Others wondered if warm weather and hay fever had a bad effect on them and their control. (For young people's experiences of the effects of diet and alcohol see 'Diet and diabetes' and 'Drinking and alcohol').

Some people found that stress during exams could raise blood glucose levels; while others felt that physical inactivity of revision for exams caused them to go high. Young people said that their levels tended to fluctuate between low and high during exam times, and that coping with blood glucose levels could be difficult and add to overall stress levels. A few young people considered themselves lucky because stress had not affected their blood glucose levels at all.

Going to university and leaving home also tended to be an unsettled time and many people had been warned by their diabetes medical team that their blood glucose level might be up and down for a few weeks while they were adjusting to a new life style. 

Other kinds of emotional highs and lows, particularly arguments with parents boy/girl friends and others could result in a high blood glucose reading.



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Last reviewed November 2015.

Last updated November 2015.

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