7 Daily Rituals to Help You Manage Type 1 Diabetes

Managing the daily demands of type 1 diabetes can be both challenging and stressful. Building healthy habits and rituals can not only help stabilize your physical health but also reduce the stress that results from living with the condition.

“People with type 1 diabetes make countless self-management decisions every day — for example, decisions about food, insulin doses, activity, sleep, and so on,” says Jacob Kohlenberg, MD, an assistant professor of medicine in the division of diabetes, endocrinology, and metabolism at the University of Minnesota Medical School. “Rituals matter because they can convert some of these decisions into automatic behaviors, which can reduce cognitive load.”

Rituals can also help improve diabetes outcomes. "We teach our patients the importance of consistency with things we can manage, which helps keep average blood glucose levels consistent,” says South Carolina-based Toby Smithson, RDN, CDCES, a senior manager of nutrition and wellness at the American Diabetes Association.

These daily practices can serve as helpful complements to your existing medical treatment and management plan.

1. Check Your Blood Sugar When You Wake Up

Measuring “your sugars when you first wake up, when you haven't eaten for a span of time, gives you your baseline,” says Joseph Monye, MD, an endocrinologist with Kaiser Permanente in Maryland. “You're then able to better track your diet and overall day, and how it affects your blood sugar.”

2. Review Your Nighttime CGM Data

“The ritual should be taking a look at your overnight CGM data each morning,” says Dr. Kohlenberg. Even if you wake up in your target range, you may be experiencing overnight low or high blood sugars that otherwise go unnoticed.

Kohlenberg says that it’s helpful to consider if a pattern is emerging over several days, such as consistent hyperglycemia. “That would suggest that your basal dose needs adjustment,” he says. The same data can help you learn whether a higher fasting blood sugar is the result of dawn phenomenon or a rebound from an overnight low blood sugar, both of which may require a different solution.

3. Take Insulin Before Every Meal and Snack

Taking your insulin before you eat — not during or after — could really help you keep your blood sugar in range in the hours after a meal or snack.

It takes some discipline to pre-bolus regularly. To get into the habit of dosing insulin before eating, Kohlenberg recommends tying the practice to something concrete. “Let's say you're at home, and you're setting the dinner table. That would be a good time to take your mealtime insulin,” he says.

And don’t ever skip your mealtime insulin doses. Kohlenberg says one of the most impactful daily rituals is dosing insulin for all carbohydrate intake, including snacks. “Missed doses of rapid-acting insulin are a major cause of high blood sugar,” he says.

For people with type 1 diabetes, “taking insulin can be cumbersome to a certain degree, but maintaining a daily regimen of making sure you take your insulin with your meals is important,” says Dr. Monye.

4. Double-Check Your Tech

Every day, make sure that your CGM and insulin pump are working properly. “Sensors can fall off, infusion sets can kink, and batteries can die,” says Kohlenberg. He suggests checking the battery life of your management devices daily.

Kohlenberg also recommends doing a quick visual check of your CGM site every day. Is the CGM still adhered correctly? Is the skin around the site irritated? Meanwhile, people using insulin pumps should make sure that insulin delivery is occurring and should check the insulin reservoir level on the pump, he says.

Finally, Kohlenberg says to keep track of when you need to change infusion sites or CGMs, and to do so according to the recommended schedule.

5. Evaluate Your Foot Health

“Chronic diabetes, especially when it's uncontrolled, starts to affect different end organs and nerves, so sensitivity in the feet diminishes, making it easier to sustain cuts and all sorts of wounds,” says Monye.

Connecting this foot inspection to an existing daily practice can help make it easier to remember: “I recommend tying this check to something you already do daily, like stepping out of the shower,” says Kohlenberg.

6. Take a Postprandial Stroll

A gentle walk can actually remove excess sugar from your bloodstream. Kohlenberg says that the movement “can be helpful to reduce the postmeal glucose rise, because with exercise, the muscles take up blood sugar.”

If you’d like to develop an after-meal walking routine, going for a postdinner stroll may be a good place to start. “We tend to have our heaviest meal at dinner,” says Monye. “You want to kick back and relax after a long day, but that's when you really need to move.”

7. Rotate Your Injection or Infusion Sites

“Injecting insulin or delivering insulin into an area with lipohypertrophy results in reduced or erratic insulin absorption,” says Kohlenberg. “Lipohypertrophy is associated with increased glucose variability.”

How to Build a Ritual Routine That Sticks

“I recommend trying to anchor new habits to existing ones,” says Kohlenberg. “For example, if you keep glucose tabs in the same drawer as your car keys, then it can become a ritual to grab them on your way out of the house.”

A major indicator that a daily ritual practice is working well is improving blood sugar control. “The hemoglobin A1C test is the main way that doctors check your average blood glucose level over time,” says Smithson. “Monitoring the amount of time that your blood glucose stays in range with a CGM can reveal how well your routine is working.”

As you work to build your new routines and habits, be patient with yourself. “It's also important to forgive yourself when you miss a day,” says Kohlenberg. “Consistency over months matters more than perfection over a week.”

The Takeaway

• Consistent daily habits and rituals for managing type 1 diabetes can help stabilize physical health and reduce the mental strain of constant decision-making.
• Kick off your morning by checking your blood sugar when you wake up, as it will give you a baseline for making good decisions throughout your day.
• New rituals, like taking insulin when you set the dining table, double-checking your devices before you leave the house, and taking a walk after dinner, can help improve your short- and long-term blood sugar control.
• To help your new rituals stick, try linking them with things you already do every day.