Hydration and type 1 diabetes - what to drink

What can I drink with type 1 diabetes?

Drinking water is of course the best way for anyone to stay hydrated. 

In theory, you can drink anything with type 1 diabetes - just like you can eat anything with type 1 diabetes. But lots of drinks contain high amounts of sugar which will raise glucose levels, so it’s better to stay hydrated with liquids that contain little to no sugar.

If you live with or care for someone living with type 1 diabetes, you may well use high sugar drinks like fruit juice or energy drinks to treat hypoglycaemia (low blood sugar).
 

The importance of hydration for people with type 1 diabetes

About two thirds of your body is water, so hydration is important for everyone!

Hydration is vital for life, but it’s also needed for lots of processes like digestive system function, maintaining blood volume and body temperature, lubricating joints, helping our kidneys to process waste, and carrying essential nutrients, glucose and oxygen to cells^1,2. 

High blood glucose levels, or hyperglycaemia, can cause dehydration through increased urination.

This is because your kidneys are working harder to flush out excess glucose through urine³, so it’s important to stay hydrated to replace the lost liquids.

In turn, dehydration changes the level of glucose vs. water in the bloodstream, which can increase blood sugar⁴. It’s a difficult cycle, and one to try and avoid by keeping glucose levels in range as much as possible. 

How much should you drink to stay hydrated with type 1 diabetes?

The recommended intake for everyone is 6-8 glasses a day, or 1.5 to 2 litres¹. Other factors like age, sex, body weight and where you live will affect this. 

If you exercise, you’ll need to drink more to replace the fluids lost through sweat, and of course you’ll need to hydrate more if you’re in a hot climate. You may also need to drink more if you’re unwell.

Drink regularly throughout the day to keep yourself topped up.

What should you drink to stay hydrated with type 1 diabetes?

Focus on water as your main source of hydration, but most non-alcoholic liquids also count. This includes tea, coffee, milk, and soft drinks⁵.

If you don’t like plain water, you can try sparkling water, adding lemon or lime juice to your water, or sugar-free cordial.

Try to avoid drinks with added sugar. These aren’t ideal for anyone, but if you’re living with type 1 diabetes, they will likely require an insulin dose. Check the nutrition labels to help you choose the one with the lowest sugar content. 

Some fruits and vegetables also count towards your daily fluid intake, such as cucumbers, tomatoes and melon¹, as they have a very high-water content. Foods like soups and yoghurts also contain liquids.

How do I know if I’m dehydrated with type 1 diabetes?

The best signifier is the colour of your urine¹. You should aim to pass urine that is pale yellow, like straw. If it’s darker or strong-smelling, you need to drink more.

Don’t wait until you feel thirsty to drink, as this is a sign that your body is already dehydrated¹. 

Excessive thirst is one of the symptoms of type 1 diabetes, and a symptom of dehydration due to the sustained elevated blood glucose levels that occur when the pancreas stops producing insulin. 

Other signs of dehydration also overlap with symptoms of high glucose. They include⁴:

• Increased thirst or a dry mouth
• Headaches
• Dizziness
• Dry skin
• Dark coloured urine
• General fatigue
• Lack of concentration 

Hydration and blood glucose management

Keeping your blood glucose levels within range as much as possible will also help you keep healthy levels of fluid in your system.

Regularly monitor your glucose levels using a glucose meter or glucose sensor and take any necessary correction doses if your glucose is high.

The dangers of dehydration with type 1 diabetes

Hydration is important for everyone, but the combination of high glucose levels and dehydration can be particularly serious for a person living with type 1 diabetes. 

Sustained periods of high glucose can become dangerous if left untreated, and you could be at risk of developing Diabetic Ketoacidosis (DKA).

In DKA, your body breaks down fat for energy because it doesn’t have enough insulin to use the sugar in your blood. This produces chemicals called ketones, which make your blood more acidic.

DKA is dangerous. Too much acid in your blood can make you pass out in a diabetic coma or even cause death.⁶

Speak to your healthcare team if you’re experiencing frequent or sustained hypers.

 Tips for getting more fluids

• Start hydrating early. Keep some water by the bed and drink it when you wake up.
• Drink regularly throughout the day. It might be easier to drink little and often, rather than gulping larger amounts less frequently.
• Set a reminder. An hourly alarm or a tick list for 6-8 glasses alongside your to-do list can help you to remember to drink.
• Carry a water bottle with you. Having a reusable bottle with you always can serve as a reminder to drink. 
• Use an app. There are lots of hydration and fitness apps available to keep you on track!

 What drinks should I avoid with type 1 diabetes?

Sugary drinks are critical if you live with type 1 diabetes, as they can quickly raise blood sugar in the event of a hypo. 

But in day-to-day life, it’s best to avoid high sugar drinks like soda or fruit juice, as they have a very high sugar content.

Do I need to take insulin for drinks?

It depends. Some liquids - like milk, milk alternatives, milkshakes, smoothies and some soft drinks, contain carbohydrates or sugars. 

Check the carbohydrate serving on the nutrition label if you have the bottle or carton, or an app that will tell you, such as Carbs and Cals⁷ or a nutrition app. This will help you determine if an insulin dose is needed. 

Alcohol and type 1 diabetes

Alcohol can make you dehydrated, but there’s no reason not to say cheers with a drink if you live with type 1 diabetes. Look at our page on drinking alcohol with type 1 diabetes for more information. 

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