A bride and groom with their heads close together. The brides veil blows out behind her

Managing Type 1 Diabetes On Your Wedding Day

I was diagnosed with type 1 diabetes in February 2013, and we got engaged in December later that year. Type 1 was still fairly new at that stage, but by the time our wedding was approaching in March 2015 I was feeling fairly confident with handling it. I knew how to get by on a standard day and what to do in certain situations. My wedding day though? That was a whole new set-up that I had never experienced before.

By the time my wedding came around I had been using a pump for 9 months, and the Libre for 5 months. In the run up to the big day I ran through at the issues I could foresee – what happens if I go hypo at the alter? Where will I put my pump? How will I manage the alcohol and food? Do I really want the Libre on my arm in my wedding photos?

No one to be defeated I worked through all my concerns and came up with a plan to make things run smoothly on the day. I am assuming if you’re reading this that you are close to your wedding, or at the very least thinking about it – so congratulations! I have collated this quick guide to managing diabetes on your wedding day in the hope that it can help you get ahead and take away any worries you might have.

A bride and groom standing outside. The brides veil is flowing out behind her in the wind. She is wearing a strapless wedding dress and holding a bouquet of cala lillies. The groom is wearing a grey kilt

The Dress

Pick Your Dress First

This was really important for me. I didn’t want to settle for a dress that I didn’t love just because I could see a logical way of having my pump in it. I removed my pump while trying on dresses, allowing me to just relax and enjoy the process (a bit – I actually found dress shopping really stressful as I’m useless at making decisions!)

Diabetes takes a lot away from us. It can make life more stressful and chaotic than it would be without it. Don’t let it dictate the dress on your special day.

A bride in a corset wedding dress that is being done up by 2 bridesmaids in purple dresses
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Where Will An Insulin Pump Go?

Once you’ve got your dress start working out where you’re going to put your pump (if you have one!). Patch pumps are a little easier – find a spot that is comfortable, gives you good absorption and don’t make your dress bulge.

If you have a tubed pump then there are a few options. If you have a dress that allows you to wear a bra you could clip it on to that (which I do regularly when wearing dresses) or pop it in to a pouch and clip that on.

My dress was strapless, so I decided to have an inner pocket sewn in. My seamstress added a pocket on the inside of my dress, high enough up that my pump would sit comfortably in it without tugging. My seamstress seemed to enjoy the extra challenge and didn’t seem to find it an issue at all.

An insulin pump sits within a hidden pocket on the inside of a wedding dress
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But What About Bolusing?

Did you know that many insulin pumps come with a remote? No? Neither did I initially. I was using a Medtronic Veo insulin pump at the time and after a discussion with my DSN I discovered there was a remote I could use. It wasn’t perfect. I couldn’t use the bolus wizard and the bolus increments were 0.1 – but it was better than nothing and saved me from rustling around under 7 layers of material to access my pump.

I now use the Medtronic 640g. I believe the Contour Next Link 2.4 is able to be used as a remote to bolus on the 640g and 670g, but I haven’t actually tried it myself.

How About Injections?

If you prefer to use MDI (multiple daily injections) then just carry on as normal! You may want to recruit someone to help you lift your dress if it’s big, and thighs would probably be the easiest place to access.

Assign A Helper

One of my best friends has experience with type 1. She has worked at kids camps, helping the kids and checking BG regularly. She was one of my bridesmaids and on hand for whatever I needed during the day. She knew where my hypo snacks were, would recognise if I looked like I was heading for a low and could even help me count the carbs in my meal if I had needed it.

Having that 1 person there with your diabetes in mind means you can relax a little during the day. If you use a CGM you can ask them to keep an eye on that, leave them in charge of monitoring alarms and then telling you as and when you need to take action. Have them carry your pens and BG meter and generally keep an eye on things for you.

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Hypos At your Wedding

Make Use Of Temporary Basal Rates

My main concern is that the adrenaline during the ceremony would make my blood sugars drop. I set a TBR for the hour before the ceremony, plus the hour of it, of 50% to try and preempt a potential hypo and keep it at bay.

Other people react differently to stressful situations, so if you know that your blood sugars are likely to spike then set a high basal rate instead. You know your body best, and although you likely haven’t been in this exact situation before you will have been in vaguely similar ones which can give you a clue for what to expect.

A bride and groom at the alter. The veil is cover the bride's face. The image is in black and white
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Keep Snacks Available

This should be obvious – we do it every day anyway! Except you don’t tend to keep a handbag with you when you’re walking down the aisle. I have heard of women keeping a tube of glucotabs in their bouquet incase a hypo struck at the worst moment.

I chose to have snacks in my own handbag, which my mum kept during the ceremony, plus more in my mum and a bridesmaids handbag. JHogg even kept some for me in his sporran – just incase! I don’t actually think I used any of them during the day but I was glad to have them available at any point.

Food And Drink

Alcohol

Let’s be realistic for a second – alcohol can cause all kinds of havoc with blood sugars, so if you aren’t accustomed to drinking then your wedding day isn’t a great day to start! Be mindful of what you are drinking, as lovely as champagne is it contains more carbs than a gin and diet tonic. Carbs aren’t always bad when you’re drinking, as over time your blood sugars can drop quite suddenly, but I try to make sure I alternate between drinks with carbs and drinks without.

Stick to what you would usually drink and have plenty experience in.

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Don’t Forget To Eat!

It is a LONG day. Hair and make-up can often start quite early, then when your guests are having canapés you will likely be off having photos taken. Make sure you eat breakfast and lunch, and ask your caterers to set aside a few canapés for you and your new partner so you can grab a snack. We all know that our basal SHOULD keep us steady even without food, but a big event like your wedding is not the time to put your basal rates to the test.

Carb Counting

The beauty of it being YOUR wedding is that you get to choose the menu! You will know in advance what you can expect on your plate and that will give you a real head start on counting the carbohydrates for your meal. If you prefer a low carb meal then ask your caterer to make adjustments for your plate – it’s your day and you can be as demanding as you want!

A bride and groom dancing. The bride has blonde hair and is wearing a white strapless dress and a veil. The groom is wearing a grey and purple kilt with a grey jacket.
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Will The Photos Be Ruined By Diabetes On Your Wedding Day?

For this I think we will be split in to 2 camps, those who will wear their diabetes tech with pride at their wedding and those who don’t want it in their pictures.

I am usually one to wear my pump and libre with pride. You just have to look at my instagram to see images of me with my libre on my arm and my pump on my hip. More recently I’ve been using my arms for pump sites too. But do I want those in my wedding pictures? No thank you.

Type 1 is very much a part of my life, but I refuse to be defined by diabetes. I didn’t want it ever present in my wedding photos, and so I hid it.

A bride and groom having their Maryculter House Hotel wedding photos in the grounds. The are leaning against a stone wall
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Alternative Libre Sites

To be clear – Abbott do not approve of the use of the Freestyle Libre anywhere other than the arm. But that doesn’t mean we don’t do it.

In the months leading up to the wedding I tried out the Libre on various sites to find where it was most accurate for me. Everyone is different, so what worked for me may not be the same for you and you need to do your own research.

For me, I placed the Libre on my bum. I started it up a few days before the wedding so it would be accurate by the time the big day came around. My thigh is also quite accurate, but I found that I knocked it too often there. We were heading off on honeymoon the day after the wedding so I was also worried about suncream and salt water (hello Maldives!) so opted for a site that would be more out of the way. The trade off for me is that both my thigh and bum get an allergic reaction, whereas my arm doesn’t.

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Enjoy Your Day

If you’re relaxed then everything will be fine. Honestly. If you go looking for issues with your diabetes on your wedding day then you’re more likely to over treat a potential low or start stacking insulin when correcting a high. Breathe and let it happen. Enjoy yourself!

What Next?

Why not join our Facebook Group which is hub for women with all different types of diabetes. It is a safe place to ask questions, share knowledge and be open about how you are coping.