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In Type 2 diabetes the body is still able to make insulin, but it isn’t able to use it as well. This is known as insulin resistance.

This means the pancreas needs to keep making more insulin in order to control blood glucose levels. Eventually, the cells in the pancreas can become worn out and can stop making insulin. Type 2 diabetes can often be managed with lifestyle changes and medication but, as the condition progresses, many people will end up needing to inject insulin as well.

Claire Baker

Dietetic lead and programme lead for SEREN

Yvonne Davies

Nursing lead for SEREN

Dr Nirupa D'Souza

Medical co-lead for SEREN

Dr Rebekah Pryce

Medical co-lead for SEREN

SEREN-hypo-treatment-sheet-pens

Foods containing carbohydrate

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Annual assessment clinic

Your team wants to give you the best standard of care, for you to look after your diabetes, and keep you healthy and well. They will carry out checks every year which will help to spot any changes early and treat them before they become a problem.

These are set by an organisation called NICE and are known as the 7 care processes.

Some meals contain small amounts of carbohydrate and require less insulin, whilst other meals contain larger amounts of carbohydrate and therefore require more insulin.

Remember you take 2 types of insulin:

The long acting insulin, which you take once or twice a day, works for up to 24 hours and is called the basal insulin (also known as your background insulin).
The fast acting insulin, which you take with food, is called the bolus insulin. This is the insulin that you adjust to correct your blood glucose level and match the amount of carbohydrate in your food and drink.

SEREN ACTIVE Information for coaches and teachers
Sport Wales (www.sports.wales)
Adult members of the family can refer to National Exercise on Referral Programme
Local sport clubs

At the end of this section you will:

Understand what Type 1 diabetes is
Understand what happens in a person who does not have Type 1 diabetes
Understand how insulin works
Recognise the signs and symptoms of Type 1 diabetes
Understand the checks carried out at diagnosis

How we can continue to support you?

Keep in touch with us and help us understand how to help you and your family
Help us to get to know you and what is important to you in your life now and in the future
Share your diabetes data with us if you feel happy to – by uploading your devices at home
Let us know if things are tricky so we can help, or find others to support you
Come to all of your appointments where possible and let us know if you aren’t able to come so that we can rearrange them
Let us know if we’re not quite getting it right, for example, if you need more help with diabetes management

There are three different types of hypos.

Mild: This is when the blood glucose falls below 4mmol/l and is easily corrected. It is important not to ignore mild hypo symptoms and to take action straight away.

Moderate: This is when the blood glucose falls below 3mmol/l. You may require help from someone else as your brain will struggle to make the right choices when your blood glucose level is very low.

Severe: If you have a severe hypo you will not be aware of it and you will require help from your family. Severe hypos are extremely rare and your family will be taught how to manage them.

If you have a severe hypo you will not be aware of it and you will require help from your family. Severe hypos are extremely rare and your family will be taught how to manage them.

This is when the blood glucose falls below 3mmol/l. You may require help from someone else as your brain will struggle to make the right choices when your blood glucose level is very low.

This is when the blood glucose falls below 4mmol/l and is easily corrected. It is important not to ignore mild hypo symptoms and to take action straight away.

Hypoglycaemia

If you break down the word hypoglycaemia, you can see what it means:
Hypo = “low” Glyc = “glucose” Aemia = “blood”

So rearranging these words gives “low blood glucose”

Builds confidence and social skills
Develops co-ordination
Helps to maintain a healthy weight
Strengthens bones and muscles
Improves sleep
Improves concentration and learning
Improves health and fitness
Makes you feel good
Helps the body use insulin more efficiently

(reference UK Chief Medical Officer’s Physical Activity Guidance)

Fear of needles

You may now have realised that injecting insulin will be a routine part of your life. Living with a fear of needles can make living with diabetes really tricky.

If you find giving your insulin injection a struggle your team can help and may offer suggestions or injection aids.

They can give you a self-help book written by a clinical psychologist called ‘Talking Type 1…Not OK with needles?’.

Timing of fast-acting insulin dose

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Traditionally it was recommended to give fast acting insulin 15 to 20 minutes before food. However, the newer ultra fast acting insulins can be given just before food.

Fast acting (bolus) insulin (e.g. Novorapid/ Humalog) should be taken 15-20 minutes before food
Newer ultra fast insulin (e.g. Fiasp) can be taken just before food
Delaying your bolus insulin can result in a glucose spike (see graph above)

Bolus Insulin

The fast acting insulin, which you take with food, is called the bolus insulin

Basal Insulin

The long acting insulin, which you take once or twice a day, works for up to 24 hours and is called the basal insulin (also known as your background insulin)

At the end of this section you will:

Understand how to carry out a blood glucose check and why it is important
Recognise the different times when it can be useful to check blood glucose
Be aware of the different blood glucose targets for different times of the day
Understand how to perform a blood ketone check
Understand what the ‘honeymoon period’ is
Recognise that there are alternative ways of measuring glucose
Understand what HbA1c is and the target value

At the end of this section you will:

Understand the types of insulin: basal and bolus
Understand how to calculate starting insulin dose
Understand how to correct a high blood glucose
Understand how to give an insulin injection
Understand where insulin can be injected
Understand why it is important to rotate injection sites

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Understand what wellbeing is and why it is important

Understand that all emotions are normal

Recognise the different ways to support wellbeing

Develop a coping plan