Daily management

Before you developed type 1 diabetes (T1D), your pancreas would release a low level of insulin throughout the day and also produce surges of insulin in response to food. Having T1D means that you need to do the job of the pancreas yourself. This means administering the appropriate type and amount of insulin at the appropriate time and managing your lifestyle to try to maintain a hold on fluctuating blood glucose levels. 

“Must–have” equipment 
There are some key items you should not be without, and should replace when supplies run low. While you may feel that carrying some of these items around is tedious, they give you flexibility. If you’re out and decide to stay overnight at a friend’s place, you’ll be glad you took your overnight insulin with you. Carrying your meter with you will let you eat unfamiliar foods, confident you can test your blood glucose level afterward to check whether you’ve taken the right amount of insulin. 

It’s a good idea to have a bag that contains enough pockets so you can quickly find what you’re looking for, and protects items from being damaged. Bags specifically made for this purpose can be found by typing “diabetes bag” into an internet search engine. 

“Must–have” items to keep on hand: 

  • Insulin, insulin pen, or insulin pump 
  • Syringes, pen needles, or infusion sets 
  • Sharps container 
  • Blood glucose monitor and testing strips 
  • Lancet devices 
  • Book to record blood glucose levels 
  • Blood or urine ketone strips 
  • Snacks to treat low blood sugars 
  • Glucagon 
  • Identification 
  • Emergency contact numbers 

Insulin, insulin pen, or insulin pump 
You should always carry insulin and the means of delivering it with you, even when you don’t expect to eat, since you never know when you might be out longer than you expect. Be careful to regularly check the amount of insulin left in your vial, cartridge, pen, or pump, since you don’t want to run out of insulin. Insulin pump users should also carry a spare infusion set and inserter as a back-up, as well as spare syringes just in case. 

If you use intermediate or long-acting insulin, you should take it with you when you go out at night. If you end up sleeping over at someone’s place, you won’t miss your evening or morning injection. It is also a good idea to keep a spare insulin pen and extra insulin in the refrigerator at work in case you accidentally leave your insulin at home. Remember to keep track of the expiration dates of your supplies at work. 

Insulin can be damaged by low (freezing) or high temperatures so don’t leave your insulin in your glove box, in direct sunlight, or anywhere that gets extremely hot or cold. Insulin can be kept at room temperature for one month, after which it should be thrown out. Some types of insulin are more sensitive than others to high and low temperatures. See the insert in your insulin package or visit the manufacturer’s website for more specific storage instructions. 

Syringes, pen needles or infusion sets 
Syringes, insulin pens, and insulin pumps all serve the same purpose: to deliver insulin to people with diabetes, who do not produce insulin on their own. Syringes or insulin pens are both used for injections, but both essentially do the same thing. Some people find the pen to be more convenient. Some people also find the pen needles more comfortable than the syringes. 

Sharps container 
A sharps container is essential for safely disposing of used pen needles, syringes, or lancets in your home. Medical sharps containers are available from pharmacies. 

Blood glucose monitor and testing strips 
It might be tempting to leave your meter at home; however, knowing what your blood glucose levels are doing will help you avoid hypoglycemia and reduce your risk of high blood glucose levels. Of course you can’t test without a lancing device so make sure you pack that, too. 

Carrying spare lancets for your lancing device (or using one of the new lancing devices which store multiple fresh lancets inside them) will reduce any blunt lancet testing pain while you are out. Additionally, you have a choice when it comes to lancing devices – you don’t necessarily have to use the one that comes with the meter; it’s ok to mix and match to find a lancing device that works best for you. If your meter is taking up too much space in your kit, have a look at the different sized meters available. 

Keeping a spare meter and test strips at work or in a frequently used bag can help you avoid the stress of forgetting your meter and then spending a day wondering if your blood glucose levels are going high or low. It’s important to have clean fingers when you test your blood glucose levels, as the accuracy of your test can be impacted by the presence of food on your fingers. Usually you will be able to wash your hands, but for those times when you can’t, you may want to carry some finger wipes with you. However, if you do clean your finger first, be sure to have it dry before testing. 

Book to record blood glucose levels 
It is important to note that “perfect” blood glucose levels are quite uncommon. If you record your blood glucose levels and share your results, including the “bad” days, with your health care team, they will be able to help you manage your diabetes better. But, if you don’t record or share your results (or if you make them up), you won’t be able to benefit from their feedback and suggestions. Companies that manufacture insulin or blood glucose meters often provide blood glucose record books free of charge. You can also check at your local pharmacy for booklets. 

Ketone strips 
Ketones are a product of fat. They accumulate in the blood as a result of inadequate insulin (often due to illness) or inadequate food or energy intake. Having some way to test for ketones, either using urine strips or blood test strips with a ketone testing device will enable you to identify whether you are at risk of ketoacidosis. Ketone strips can be purchased in individual foil wrapped strips, which have a longer shelf life. 

Snacks to treat low blood sugars 
Always carry at least one treatment for low blood glucose with you at all times. If your blood glucose level is low, you will need to consume food or drink that contains around 15g of carbohydrates to help bring your blood glucose level back into the normal range. Speak with your health care professional to understand how to treat a low blood sugar. It can be hard to walk around all day with your favorite candies in your pocket, so try to carry glucose tablets instead of food to reduce the temptation to snack when you’re bored or hungry. 

Your treatment for low blood glucose will often be in your bag (or pocket) for a while, so you need something with resilient packaging, or a small airtight plastic container to keep it safe from opening or getting squashed. 

Glucagon and severe low blood sugar emergencies 
People with diabetes who experience severe low blood sugar emergencies (altered mental status, loss of consciousness or seizure) may require glucagon. Glucagon raises the blood sugar when a person with diabetes is unable to swallow liquid or food because of severe sleepiness, unconsciousness, or seizure activity. Glucagon, like insulin, must be injected with a syringe. It is a hormone that helps the liver release glucose in order to raise blood sugar levels. If you need glucagon, you will not be able to administer it yourself. Read the directions carefully – and train a trusted friend or companion how to administer it and when. Ask your healthcare provider for more information. 

Identification 
You should always wear a medical alert bracelet that identifies you as a person with T1D. You should also carry a card in your wallet or purse that provides your doctor’s contact details and a brief description of the medication you are taking. In the (hopefully unlikely) event you have an emergency; the identification will enable health professionals to quickly provide the care you need. 

Emergency contact numbers 
Emergencies can happen at any time, so make sure those around you know whom to contact in an emergency. Also, be sure you know whom to contact if you become unwell overnight or on the weekend.

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