If your friend, housemate or someone else you know has diabetes, it can affect their daily life particularly if they take medication for it. This can be insulin or other types of diabetes medication. So it’s useful to know what to expect.
They may never need your practical help unless they have a diabetes emergency. But they will welcome your understanding and tact, particularly if they’ve recently found out they have diabetes.
“It’s amazing to be able to speak to someone who understands my type of diabetes so I don’t have to keep repeating myself.”
People with type 1 diabetes, some people with type 2 diabetes and some people with rarer types of diabetes can’t live without insulin. It’s something the rest of us don’t have to worry about as our body already has a good supply.
They’ll inject insulin several times a day using an insulin pen. Or they have an insulin pump, a battery-operated device that attaches to their body and pumps the insulin they need.
They may need to change how much or the type of insulin they take depending on things like what they’re eating or what they’re doing. They’ll need to store their spare insulin in a fridge or something like a Frio cooling wallet if they’re out and about in the heat or travelling.
If they don’t like injecting insulin in public, they will need to find somewhere private where they feel comfortable doing so.
Finger-prick testing to check blood sugar levels
People who use insulin or take medication like sulphonylureas check their blood sugar levels several times a day or more by doing a finger prick test. It doesn’t matter where they are – they could be shopping or in a meeting. Checking their blood sugar levels shows them if their blood sugar is going too low (hypo) or too high (hyper). If this happens, they’ll need to treat it, to prevent it becoming a problem.
“When I check my blood or inject insulin in front of you, it’s a normal part of my life. If you want to ask questions, go ahead, but don’t stare at me like I’m on display.”
If you notice that someone has a small white disc on their arm, it's a flash glucose monitor or a continuous glucose monitor (find out the difference between them). Both send blood sugar readings to a device so people with diabetes can keep a closer eye on their blood sugar levels. This means they will need to do fewer finger-prick tests.
Low blood sugar (hypos)
If your friend checks their blood sugar and it’s going too low (below 4mmol/l), this is called a hypo. Hypos can often affect people who use insulin or other diabetes medication like sulphonylureas.
If people find it hard to recognise the signs of a hypo, they’ll need to check their blood sugar more often. Some people get really worried about having hypos which is called hypo anxiety.
If your friend has a hypo, they’ll need to eat something sugary – like a handful of sweets or a sugary drink. This sounds odd. But a diet drink or foods won’t help. They need something with actual sugar to bring their blood sugar levels back up. If your friend is acting out of character, perhaps gently suggest they should test their blood sugar as they may be having a hypo.
“Always keep sugary foods in your house for friends with diabetes.”
High blood sugar (hypers)
A hyper is when someone’s blood sugar is going too high (above 10mmol). If your friend has a hyper, they may need to have a dose of insulin or other diabetes medication.
They may or may not recognise the signs of a hyper unless they’ve checked their blood sugar.
Food and eating out
People with diabetes don’t need to eat special food. But like everyone, should try and eat a healthy balanced diet. It doesn’t have to be sugar free. But food will affect their blood sugar. So they may need to be more careful about what they eat – and have fewer treats, particularly if they have type 2. Many people with type 1 diabetes can do something called carb counting. This means they match how much insulin they take to what they eat or drink. This helps them look after their blood sugar levels.
“Please don’t question what I eat or drink or comment on my weight. And please don’t pressure me into eating or drinking anything if I’ve already said no.”
Don’t worry about asking people with diabetes out for a meal. They can plan ahead and carry extra snacks in case they can’t eat at the time they usually do.
People with diabetes can drive. But it’s not safe to drive if they are having a hypo (low blood sugar). If they are at risk of hypos (low blood sugar), every time they drive they’ll follow a checklist to keep everyone safe. This means they may sometimes arrive later than planned. Or if you’re going on a trip together and they’re driving, your journey may sometimes be delayed.
On long journeys they should take a break every two hours and not delay meals. If they do have a hypo while driving (low blood sugar) they’ll need to pull over and treat it.
Being physically active is good for everyone including people with diabetes. So they can join you on anything from a hike to a night of dancing. But it’s useful to be aware that activity can affect blood sugar levels so if they are at risk of hypos they may need to take more breathers to check their blood sugar levels. And if they have a hypo, they’ll need to eat something sugary and rest until they are better.
People with diabetes can drink alcohol. But they’ll need to be more careful if they’re at risk of low blood sugar as alcohol can increase the risk. Like everyone, it’s important that they don’t drink on an empty stomach. The effects of alcohol can last for some time so if you’re staying with your friend, you may want to encourage them to test their blood sugar and eat something before they go to bed.
Don’t just assume your friend is drunk if they’re showing signs of it – as the signs of low blood sugar can be similar.
Holidays and trips away
There’s no reason not to go on holiday with someone with diabetes or a weekend away, at a festival for example. They’ll know how to look after their diabetes. If they have hypos, they may just need to pace themselves a little. It’s always sensible to ask them for a contact number of someone you can call in the event of an emergency.
How people feel about their diabetes
There’s much more to people than their diabetes. And they’d often prefer you didn’t make a big deal about it.
“Please don’t introduce me as 'This is Nieve she has diabetes.’ It’s my business if I choose to disclose whether or not I have diabetes.”
“Don’t reduce me to my diabetes. I am more than that. It's worth knowing that I can be in a bad mood without it being that I’ve got high or low blood sugar.”
But it’s good to be aware that the pressure of living with diabetes – from health appointments to testing and injecting – can be emotionally tough sometimes. Not to mention the worry and awareness that high blood sugars over the years can cause damage to parts of the body known as diabetes complications.
“The thousands of extra decisions I make daily can wear me down and I need a break every now and then.”
“I hope I support Laura as much as I can – from small things like tasting her popcorn in the cinema to see if it’s as sweet as usual to checking she hasn’t injected too much insulin to getting a place in the London Marathon to run in her honour.” Laura and Zoe’s story
Lots of people with diabetes live without ever needing emergency treatment. But both extreme high or low blood sugar levels can need emergency treatment and can rarely cause people to have a diabetic seizure (sometimes called a fit) or become unconscious (sometimes called a diabetic coma).
If someone with diabetes is unconscious or fitting, do not give them any food or drink. They may be having a severe hypo. See what to do if they have a severe hypo. If in any doubt call an ambulance.
If someone is confused or passing out or has other symptoms like constant thirst and high blood sugar or blurred vision, call for help as soon as possible. They may be developing a serious condition caused by very high blood sugar called Diabetic Ketoacidosis (DKA) — a severe lack of insulin — or Hypersomolar Hyperglycaemic State (HHS).