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Some super important things to know about diabetes right now

Me and my emotions

Your diabetes team

Wellbeing reminder

What is Diabetes?

What is Type 1 diabetes?

Where is insulin produced?

Insulin and Diabetes

Introduction to insulin and diabetes

Bolus and Basal insulin

Injection sites

Giving an insulin injection

Rotating your injection sites

Glucose and Ketone Monitoring

Glucose monitoring

Useful times to check blood glucose

Recording blood glucose readings

Honeymoon period

Continuous glucose monitoring (CGM)/flash monitoring

Food and Diabetes

Food is an important part of life

The Eatwell Guide

Learning more about carbohydrate

What is hypoglycaemia

Causes of hypoglycaemia

Signs and symptoms

Treating your hypos

Activity and Diabetes

Managing blood glucose during activity

Carbohydrate adjustments for exercise

Carbohydrate for exercise

Carbohydrate Counting

Introducing carbohydrate counting

Carbohydrate counting resources

Calculating carbohydrate by weighing portions

Insulin Dose Adjusting

Insulin dose adjusting

Insulin to carbohydrate ratio (ICR)

Insulin sensitivity factor (ISF) or correction dose

Illness and Diabetes

Illness and Diabetes

Low blood glucose levels

Calculating extra insulin dose for illness

What is Wellbeing?

Riding the waves – living alongside diabetes

Being kind to yourself

Top tips for coping

Things you can expect from us

Getting involved with research

References and Helpful Links

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All about Me 4 Topics

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Some super important things to know about diabetes right now

Me and my emotions

Your diabetes team

Wellbeing reminder

What is Diabetes? 4 Topics

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Section Content

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What is Type 1 diabetes?

Where is insulin produced?

Insulin and Diabetes 6 Topics

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Section Content

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Introduction to insulin and diabetes

Bolus and Basal insulin

Injection sites

Giving an insulin injection

Rotating your injection sites

Glucose and Ketone Monitoring 8 Topics

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Glucose monitoring

Useful times to check blood glucose

Recording blood glucose readings

Honeymoon period

Continuous glucose monitoring (CGM)/flash monitoring

Food and Diabetes 5 Topics

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Section Content

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Food is an important part of life

The Eatwell Guide

Learning more about carbohydrate

Hypoglycaemia 6 Topics

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What is hypoglycaemia

Causes of hypoglycaemia

Signs and symptoms

Treating your hypos

Activity and Diabetes 4 Topics

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Section Content

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Managing blood glucose during activity

Carbohydrate adjustments for exercise

Carbohydrate for exercise

Carbohydrate Counting 4 Topics

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Section Content

0% Complete 0/4 Steps

Introducing carbohydrate counting

Carbohydrate counting resources

Calculating carbohydrate by weighing portions

Insulin Dose Adjusting 4 Topics

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Section Content

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Insulin dose adjusting

Insulin to carbohydrate ratio (ICR)

Insulin sensitivity factor (ISF) or correction dose

Illness and Diabetes 5 Topics

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Section Content

0% Complete 0/5 Steps

Illness and Diabetes

Low blood glucose levels

Calculating extra insulin dose for illness

Wellbeing 4 Topics

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Section Content

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What is Wellbeing?

Riding the waves – living alongside diabetes

Being kind to yourself

Top tips for coping

Expectations 4 Topics

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Things you can expect from us

Getting involved with research

References and Helpful Links

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Copyright © 2025 The Children and Young People’s Wales Diabetes Network (CYPWDN), Cardiff and Vale University Health Board

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.

Dr Rebekah Pryce

Medical co-lead for SEREN

Dr Nirupa D'Souza

Medical co-lead for SEREN

Yvonne Davies

Nursing lead for SEREN

Claire Baker

Dietetic lead and programme lead for SEREN

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

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.

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

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

At the end of this section you will:

Understand that there are a range of emotions that can be felt following a diagnosis of diabetes
Understand that there are different diabetes team members and roles
Share information about themselves

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

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”

SEREN-hypo-treatment-sheet-pens

If you break down the word (Hyperglycaemia), you can see what it means:

Hyper = “high” Glyc = “glucose” Aemia = “blood”

So rearranging these words gives “high blood glucose”

Checking your blood glucose levels frequently is also beneficial in the longer term as it helps you and your diabetes team to change your insulin doses and ratios.

Blood glucose levels are measured in millimoles per litre, which is written as mmol/l. Your diabetes team will help you learn how to measure your blood and ketone levels.

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

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.

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.

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.

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.

Hypoglycaemia

Hypo = “low” Glyc = “glucose” Aemia = “blood”
So rearranging these words gives “low blood glucose”

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.

At the end of this section you will:

- Understand the principles of healthy eating for people with Type 1 diabetes
- Consider the different aspects of their own family’s mealtimes
- Recognise the benefits of mindful eating
- Recognise the three main nutrients: protein, fat, and carbohydrate and why they are important
- Have an awareness of the different sources of carbohydrates in their diet

At the end of this section you will:

- Understand what hypoglycaemia (hypo) means
- Recognise the possible causes of hypoglycaemia
- Recognise the signs and symptoms of hypoglycaemia
- Understand that glucose is required to treat a hypo and that the recommended amount varies according to body weight

At the end of this section you will:

Recognise which foods and drinks contain carbohydrate
Understand the benefits of carbohydrate counting
Understand the principles of insulin dose adjustment
Use a range of information to calculate the carbohydrate value of food and drinks

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

At the end of this section you will:

- - Recognise the importance of physical activity
  - Understand the possible effects of exercise on blood glucose
  - Understand that you will need to make a plan for managing blood glucose during exercise

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)

Foods containing carbohydrate

Foods containing carbohydrate

At the end of this section you will:

- Further understand the link between carbohydrate intake and insulin dose
- Recap on basal and bolus insulin doses
- Understand what an insulin to carbohydrate ratio (ICR) is
- Learn how to calculate insulin doses using ICR
- Understand what a correction ratio, or insulin sensitivity factor (ISF), is

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)

At the end of this section you will:

- - Understand how illness affects blood glucose levels and can lead to the production of ketones
  - Recognise the symptoms of Diabetic Ketoacidosis (DKA)
  - Understand the importance of following sick day rules if unwell
  - Recognise how to respond to blood glucose and ketone levels
  - Understand how to manage low blood glucose during illness

Starting-blood-glucose-level-mmoll-42-x-70-cm-1

At the end of this section you will:

- - - 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

At the end of this section you will:

Understand what to expect from the diabetes team
Understand your role in looking after your diabetes
Be aware of how clinic is set up
Understand the different care processes and why they are carried out
Know that there are a range of SEREN education modules

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?’.

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)

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Cymraeg (Welsh)