Diabetes type 1

Everyday factors that affect diabetes control

Controlling your diabetes means thinking about how ordinary things, that others might not need to think about, will affect you. When should you eat, how much can you eat, when should you exercise and for how long, are all everyday things that young people coping with diabetes have to learn to work out for themselves on an individual basis.  

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 is an important factor in control and brings down blood glucose levels. Those who play sport have to be precise about the insulin and carbohydrate they need before a game or activity. 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 your long-term blood glucose control. It is a test done at the clinic every three months or so and provides a good guide as to whether your treatment is working well or whether it needs to be adjusted. 

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's results over several years.

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 maintained 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.

External factors that can affect diabetes
Many young women said that their blood glucose levels tend to fluctuate between low and high before and after their periods. One young woman was prescribed a contraceptive pill to regulate her periods and she expects to take it until her twenties or when her blood glucose levels become more stable. Another young woman stopped taking the pill because she found that her blood glucose levels went very high during the time of her period.

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').

Stress during exams could raise blood glucose levels according to some young people; others felt that the root cause of the problem was the physical inactivity of revision for exams. 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.

Last reviewed April 2012.

Last updated April 2012.


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