Pathway Step 4 · Build your kit

🧰 Patient Tools Kit — Type-1-Diabetes

The everyday tools a Certified Prepared Patient keeps within reach: the rules that decide an emergency, the order to make calls, and the trackers that keep the routine on course. Print the cards, fill in your contacts, and keep this kit where the whole household can find it.

What’s in your kit

Eight tools. The first three are the rules you must know cold — they decide when something is an emergency. The rest keep the daily partnership steady and tell you where your role begins and ends.

1 The DKA Rule 2 The Hypoglycemia Rule 3 Other Red Flags 4 The Contact Ladder 5 Time in Range 6 T1D Insulin 7 The ER Go-Bag 8 Speak Up / Trust the Team
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1 · The DKA Rule

Know this cold

Diabetic ketoacidosis (DKA) is a life-threatening emergency in type 1 diabetes. It happens when insulin is missed, during illness, or when the pump fails. Hours matter.

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T1D DKA RULE

Patient card
Sugar over 250 + sick
High sugar + nausea + vomiting + belly pain + deep rapid breathing + fruity breath + extreme thirst.
Test ketones
Blood ketones over 1.5 mmol/L (or urine ketones moderate-to-large) + high sugar = ED. Even before symptoms get severe.
NEVER skip insulin
Sick days raise insulin needs — not lower. Always take basal insulin. Sick-day rules guide bolus adjustments.
Your move as patient: Check sick-day rules together. Push sugar-free fluids. Test sugar AND ketones during illness. Severe vomiting + cannot keep fluids = ED.
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2 · The Low Sugar Rule

Know this cold

Low blood sugar in T1D can happen quickly — especially with too much insulin, missed meals, alcohol, or exercise. Catching it early prevents seizures, unconsciousness, accidents.

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T1D HYPO RULE

Patient card
70 mg/dL or lower
Treat low sugar: 15g fast carbs (juice, glucose tabs), wait 15 min, recheck. Repeat if still low.
Cannot swallow
If patient is too confused to drink or eat — use glucagon (injection or nasal spray) and call 911.
CGM alarms
Continuous glucose monitor (CGM) alarms catch lows before symptoms. Don’t silence them.
Your move as patient: Keep glucose tabs and juice everywhere. Know where glucagon is. If you looks shaky, sweaty, confused — check sugar first. Don’t silence CGM alarms.
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3 · Other Red Flags — Emergencies

Know this cold

Beyond the two red rules above, these situations also mean immediate help. When in doubt, the home care plan handles ordinary days — these are not ordinary.

🫕 DKA signs

High sugar + vomiting + fruity breath — ED now.

Call 911 now

🔥 Severe low sugar

Confused, seizure, unconscious — glucagon + 911.

Call 911 now

👣 Foot wound

Diabetes patients can have neuropathy and miss foot wounds. Red, draining, painful — ED today.

Call 911 now

❤️ Chest pain

T1D raises cardiovascular risk over time. New chest pain — 911.

Call 911 now
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4 · The Contact Ladder

Fill in & print

When something is wrong, you should not be deciding who to call in the moment — only which rung you are on. Fill in the names and numbers now, while things are calm.

1
Rung 1 · The plan

You's T1D plan + sick-day rules

Daily insulin doses, carb counting, CGM, pump settings, sick-day rules.

Action plan kept: ________________________
2
Rung 2 · The specialists

Endocrinology / diabetes educator

For insulin adjustments, pump issues, CGM questions. CDEs are gold.

Specialty team: ________________________
3
Rung 3 · Everyday care

Primary care provider

For non-diabetes care, vaccines.

Primary care: ________________________
4
Rung 4 · Emergency

911 / Emergency Department

For DKA, severe low sugar (after glucagon), other emergencies.

Preferred ED: ________________________
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5 · Daily Time-in-Range %

Tap to log

CGMs report time-in-range (sugar 70-180). Track daily — the trend matters more than any single number.

Goal: 70%+ in range for most patients. Bring CGM data to endo visits.

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6 · T1D Insulin Support

Daily routine

Insulin is essential — T1D patients make none. Multiple types: rapid (mealtime), long-acting (basal). Many use insulin pumps + CGM. New automated insulin delivery (AID) systems are transforming care.

The reality: T1D management is 24/7. Pumps and CGMs help but require constant attention. Your job as patient is supportive — learn the technology, know where glucagon is, recognize lows, watch for DKA during illness.

Insulin storage

Unopened in fridge. In use: room temp up to 28 days. Never inject cold.

Pump emergencies

Pump failure or kink — sugar rises FAST. Know the manual injection backup. Have spare insulin on hand.

CGM alarms

Don’t silence them. They catch lows before symptoms. Make sure your phone is paired and audible.

AID systems

Closed-loop systems (Tandem Control-IQ, Omnipod 5, Medtronic 780G) automate insulin. Game-changers — ask if eligible.

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7 · The ER Go-Bag

Pack once, check monthly

A crisis is not the time to gather paperwork. Pack a go-bag now and keep it by the door. Tap each item as you add it — your checklist saves on this device.

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8 · Speak Up / Trust the Team Guide

You boundary

The hardest skill in patienting is knowing when to act and when to hold back. A great patient is a reliable backup and a fierce advocate — without taking your own care away from them.

💬 Speak up when…

  • A red-flag rule is met and a clinician is dismissing it — restate the rule and the home plan calmly and clearly.
  • You are in the ED and your home plan is being ignored — ask for it to be looked at, and ask for a senior clinician if needed.
  • You are about to be given a medicine or test that wasn’t in the plan — ask why, and ask about alternatives.
  • Your symptoms are escalating between visits — call before it becomes an ER trip.
  • You feel unheard or rushed — it’s OK to say "I need a minute to ask one more question."

🤝 Trust the team when…

  • They have proposed a guideline-based treatment that fits your plan.
  • You disagree from fear rather than from new information — pause, ask one question, listen.
  • You are on a stable run that’s working — small adjustments often beat big changes.
  • Your care partner’s instinct and the team’s recommendation agree — that’s a strong signal.
  • You’ve done your part of the homework — logs, questions, honest history — and now it’s the team’s turn.
The principle: you trained to the depth your clinicians use so you could be a partner in your own care, not a passenger. Speak up for safety and accuracy; trust the team for guideline-based treatment and steady adjustment. When unsure, ask a clarifying question first: “Can you walk me through your reasoning?”
← Back to the Type-1-Diabetes Patient pathway · then mark Step 4 complete