What you need to know: Glucose concentrations in type 1 diabetes are affected by multiple interacting and independent complex factors. Structured education programmes support effective self management and should be available to everyone with an established diagnosis of type 1 diabetes. Long term self-management of type 1 diabetes is challenging and requires ongoing support from an expert multidisciplinary team. Insulin dose adjustment involves carbohydrate estimation and mental arithmetic, which can be supported with technology. Healthcare professionals should be alert to signs of depression or distress in people with type 1 diabetes, and access to psychosocial support is critical.