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Diabetes cannot be cured, but treatment aims to keep your blood glucose levels as normal as possible, and to control your symptoms to prevent health problems developing later in life.

If you have been diagnosed with diabetes, you'll be referred for specialist treatment from a diabetes care team. Your care team will be able to explain your condition to you in detail and help you to understand your treatment. They will closely monitor your condition in order to identify any health problems that may occur.

As well as receiving medical treatment, there are a number of ways you must treat the condition yourself (see the 'self help' section). 

Insulin treatments

As type 1 diabetes occurs because your body cannot produce any insulin, you will need to have regular insulin treatment for life in order to keep your glucose levels normal.

Insulin comes in several different preparations, which each work slightly differently. For example, some are long-acting (lasting up to a whole day), some are short-acting (lasting up to eight hours), and some are rapid-acting (which work quickly, but do not last very long). Your treatment may include a combination of these different insulin preparations.

Insulin injections

In most cases of type 1 diabetes, you'll need to have insulin injections. Insulin must be injected because it is a protein and the enzymes in your stomach would digest it like a food if it was taken as a tablet. When you are first diagnosed, your diabetes care team will help you with your insulin injections, before showing you how and when to do it yourself. They will also show you how to store your insulin and dispose of your needles properly.

Insulin injections are given using a syringe or an injection pen, which is also called an insulin pen (auto-injector). Most people need two to four injections a day. Your GP or diabetes nurse may also teach one of your close friends or relatives how to inject the insulin properly.

Insulin pump therapy

This is an alternative to injecting insulin. An insulin pump is a small device (about the size of a pack of playing cards) that holds insulin.

The pump is attached to you by a long piece of thin tubing, with a needle at the end, which is inserted under your skin. Most people insert the needle into their stomach, but you could also insert it into your hips, thighs, buttocks or arms.

The pump allows insulin to flow into your bloodstream at a rate that you can control. This means you no longer need to give yourself injections, although you will need to monitor your blood glucose levels very closely to ensure you are receiving the right amount of insulin.

Insulin pump therapy can be used by adults, teenagers and children (with adult supervision) who have type 1 diabetes. However, it may not be suitable for everyone. Your diabetes care team may suggest pump therapy if you often have hypoglycaemia (low blood glucose).

Insulin jet system

This is a new device for delivering insulin without using a needle, and is now available on the NHS. The insulin jet system can be used on your stomach, buttocks and thighs.

It works by forcing a very small stream of insulin through a nozzle that is placed against your skin. The insulin travels at a very high speed and goes through your skin. Your diabetes care team will be able to advise you about whether this method of insulin delivery is suitable for you.

Monitoring your own blood glucose levels

An important part of your treatment will be making sure your blood glucose level is as normal and stable as possible.

You will be able to manage this using insulin treatment and by eating a healthy diet, but you'll also have to regularly check your blood glucose levels to make sure they are not too high or too low.

Exercise, illness, stress, drinking alcohol, taking other medicines and (for women) changes to hormone levels during the menstrual cycle can all affect your blood glucose levels.

In most cases, you'll need to check your blood glucose levels at home using a simple finger prick blood test. You may need to do this up to four or more times a day, depending on the type of insulin treatment you are taking. Your diabetes care team will talk to you about your ideal blood glucose level.

The normal blood glucose level is 4.0-7.0 mmol/l before meals, and less than 9.0 mmol/l two hours after meals. Mmol/l means millimoles per litre, and it is a way of defining the concentration of glucose in your blood.

Find out how to test your glucose levels (opens in new window) 

Having your blood glucose levels checked

As well as monitoring your own blood glucose levels every day, your GP or diabetes care team will want to do a special blood test every two to six months. This shows how stable your glucose levels have been over the past six to twelve weeks, and how well your treatment plan is working.

This is known as the HbA1c test. It gives an idea of blood glucose levels over time, unlike the finger prick tests that people with diabetes can do themselves, which measures blood glucose at a single time.

It measures the amount of the oxygen-carrying substance in red blood cells (haemoglobin) that has glucose attached to it. A high HbA1c level can mean that your blood glucose level is consistently high, and your diabetes treatment plan may need to be altered.

A new way of reporting HbA1c results is being introduced on June 1 2009, initially alongside the way of recording it that many diabetes patients will already be familiar with.

For more information on these changes and why they are happening, please see Changes to how HbA1c results are reported

Treating hypoglycaemia (low blood glucose)

Hypoglycaemia can occur when your blood glucose level becomes very low. It is likely that you will develop hypoglycaemia from time to time.

Mild hypoglycaemia (or a 'hypo') can make you feel shaky, weak and hungry, and can be controlled by eating or drinking something sugary, such as a fizzy drink (not diet), sugar cubes or raisins. You may also be able to take pure glucose in a tablet or fluid, if you need to control the symptoms of a hypo quickly.

However, if you develop severe hypoglycaemia, you can become drowsy and confused, and you may even lose consciousness. If this occurs, you will need to have an injection of glucagon into your muscle, which is a hormone that quickly increases your blood glucose levels.

If you have type 1 diabetes, you may need to carry glucagon with you at all times, and your diabetes care team may show several of your family members and close friends how to inject the glucagon into your muscle, should you need it.

Once you begin to come round, you will need to eat something sugary once you are alert enough to do so. If you lose consciousness as a result of hypoglycaemia, there is a risk that it may happen again within a few hours, so you will need to rest afterwards and have someone with you.

If the glucagon injection into your muscle does not work, and you are still drowsy or unconscious 10 minutes after the injection, you will need urgent medical attention.

You'll need to have another injection of glucagon straight into a vein, which must be given by a trained healthcare professional.

Treating hyperglycaemia (high blood glucose)

Hyperglycaemia can occur when your blood glucose levels become too high. It can happen for several reasons, such as eating too much, being unwell or not taking enough insulin.

If hyperglycaemia occurs, you may need to adjust your diet or your dosage of insulin, in order to keep your glucose levels normal. Your diabetes care team will advise you about the best way to do this.

However, if hyperglycaemia is left untreated, it can lead to diabetic ketoacidosis, which can eventually cause unconsciousness and even death.

Diabetic ketoacidosis occurs when your body begins to break down fats for energy instead of glucose, leading to a build-up of acids in your blood. See the 'symptoms' section for the warning signs of diabetec ketoacidosis.

If you develop diabetic ketoacidosis, you will need to have urgent treatment in hospital. You will be given insulin directly into a vein (intravenously). If you are dehydrated, you may also need to have other fluids given by a drip, including saline (salt solution) and potassium.

Other treatments

If you have type 1 diabetes, you have an increased risk of developing heart disease, stroke and kidney disease. To reduce the chance of this, you may be advised to take:

• anti-hypertensive medicines to control high blood pressure,
• a statin, such as simvastatin, to reduce high cholesterol levels,
• low-dose aspirin to prevent stroke, and
• angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril if you have the early signs of diabetic kidney disease.

Diabetic kidney disease is identified by the presence of small amounts of albumin (a protein) in your urine. It is often reversible if treated early enough.

It is also recommended that you have an influenza (flu) vaccine each year, and a one-off vaccination that protects against some forms of pneumonia and meningitis (pneumococcal vaccine). These infections can be particularly unpleasant and more serious if you have diabetes.

Carers

If you are looking after someone who suffers from diabetes that affects them so much that they need you to help them with their activities, Carers Direct  can help you. On Carers Direct you can find out all about how to get help with caring for the person you look after, your legal and employment rights, and getting benefits on Carers Direct.