Often patients ask, “What should my levels be?”. The answer to this question is quite complex as it is certainly different for each individual. Daily management of diabetes for a type 1 can be quite challenging but here are some key points that I often find myself discussing with young people with diabetes.

• Stay out of danger – there is much more ‘wiggle room’ above 7mmol/l than there is below 4mmol/l. By this I mean, if we consider 4-7mmol/l to be the absolute normal values, people only start becoming symptomatic of a high glucose when levels above 15mmol/l are reached. However, the same symptoms can indicate levels of 3.5mmol/l and below.

• Test yourself regularly so that you know how you feel at various levels – don’t assume because you are hungry or tired that your levels must be low. They could also be high!
• Try to eat consistently and similarly each day so that you avoid becoming hypoglycaemic – this is obviously difficult for children who are very active and don’t want to forfeit play time at school for eating. Careful meal planning and consultation with a skilled dietitian can help in this regard.
• Meal planning is also key rather than last minute visits to the tuckshop and rushed fast foods on the way home or between extra-mural events! Dietitians do not only advise people on losing weight and how to eat provitas!

• Watch out for sport and exercise – again, children don’t tend to go to the gym for an aerobics class three times a week at the same time each day. One day they have PE during school, then its hockey practice after school and then next term it’s swimming or rugby or cricket. All different sporting codes may require different adjustments. I always recommend going to see your doctor or diabetic educator during each school holiday – go with the term sports calendar and review medication and snacks as required.
• Try as much as possible not to let levels fluctuate too much – I’m often happier with readings consistently around 10mmol/l than I am with levels jumping from 3 to 18 and everything in between.
• Know how to treat high and low glucose levels – keep a card with your glucometer with glucose sweets / Super C’s etc to treat a low as well as a rapid acting insulin pen to treat high glucose readings. Give a copy to school teachers and sports coaches so they also know what to do. Discuss with close friends – I’ve often found that friends are more willing to assist than you think.
• Keep your medication and doctor’s contact details on hand so this information can be easily obtained.
• See your doctor and diabetic educator regularly and discuss potential problems like school tours, unusual sports fixtures (eg: soccer / hockey tournaments that will last all day) or upcoming functions (eg: weddings, birthdays etc). All of these events CAN be managed and enjoyed with diabetes if you know how!

Type 1 diabetes is a challenge and it does require sometimes require the services of various health care practitioners but this is far preferable than late night runs to the emergency room and days on end in hospital.