Philip Hall and Timmy

Grief and Type 1: How Life Carries On

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This article is about something most diabetes resources tiptoe around. Grief. The death of someone you love, or the loss of something else that mattered, while you are still expected to manage a chronic condition that does not pause.

It is going to happen. Maybe it already has. Most adults living with Type 1 will, at some point, grieve a parent, a sibling, a partner, a friend, a child, a marriage, a pregnancy, a career, a home. The grief will arrive on a day you also need to check your glucose, give insulin, eat something, and not collapse.

This is a practical, calm look at what to know, and what some people have found helps. Philip Hall’s personal story sits in the middle of it, because it should.

What grief does to glucose

The acute phase of grief is a stress response. Cortisol, adrenaline, disturbed sleep, irregular eating, missed routines, alcohol that gets reached for when it usually wouldn’t. All of it shows up in glucose.

What people commonly notice:

  • Glucose runs higher than usual for days or weeks, particularly in the morning.
  • Insulin needs change in either direction depending on whether you’re eating less or eating differently.
  • Hypos can become more likely if appetite drops and meals are skipped without basal adjustments.
  • Variability widens. Days look less consistent than they used to.
  • The mental effort of doing the management at all is significantly higher.

None of this is failure. It is your body responding accurately to a meaningful event.

What you can do at the time

Tell your diabetes team

Even a short message. “Someone close to me has died. I’m going to be in grief mode for a while. My numbers will probably wobble. I just want you to know.”

Most teams will offer to widen your targets temporarily, simplify your management, or schedule a closer check-in. A few will not engage well; that is information, not your failure.

Lower the bar on management, on purpose

Pick the floor you will hold even on the hardest days:

  • Insulin given at roughly the right times.
  • Hypo treatment with you at all times.
  • Some food, however basic, several times a day.
  • Enough sleep that you are not at risk of a hypo from exhaustion.

That is enough. Time-in-range is not the goal this week. Safety is.

Be careful with alcohol

Grief and alcohol mix predictably. The risk is real because alcohol suppresses your liver’s normal hypo response. If you drink during the grief weeks, do it slowly, with food, and with someone who knows what to do if you go low. The alcohol and Type 1 article is the relevant one.

Tell one person what’s happening with your diabetes

Not the whole world. One person who can ask you, gently, every few days: “Are you eating? Are you treating lows? Are you doing the bare minimum?” Someone who can text you a reminder to test if a day has been particularly heavy.

Grief brain is real. It will let you skip the things you’ve never skipped before.

Widen your CGM alarms slightly

With your team’s input, give yourself fewer interruptions during this period. You do not need the device fighting you while you are trying to grieve. Tighten the urgent-low alarm; widen the rest. The whole purpose of the alarm system right now is to catch the genuinely dangerous and let everything else go.

A note on suicidal thoughts

Grief, particularly grief from suicide, can produce thoughts about ending your own life. So can severe depression. If this is happening to you, you are not broken, and you are not the only one. Tell someone today. Lifeline (Australia) 13 11 14, Samaritans (UK) 116 123, US 988, NZ 1737. Your GP. Your diabetes team. Your closest person. You do not have to wait until you are sure. Reaching out early is the right move.

If you have access to insulin and your thoughts have turned toward harm, ask someone you trust to hold your spare insulin and supplies for a period until you are safer. This is not weakness. It is the same logic that a person at a vulnerable moment gives their car keys to a friend for the night.

In the months after

The acute weeks become months. The grief settles into a different shape. The diabetes is still there, asking for the same daily attention. A few specific things tend to help:

  • One small consistent routine you can do every day, however basic. The diabetes management becomes part of it. There is something quietly anchoring about the consistency.
  • An honest review with your diabetes team after six to twelve weeks. The numbers will tell a story; the conversation makes that story make sense.
  • A counsellor, psychologist, or grief specialist if you can access one. Specifically asking for someone who has worked with chronic illness alongside grief makes the conversation much more useful.
  • One thing you used to do that brought you to yourself exercise, music, reading, cooking, time outside. Putting it back in slowly is part of the recovery, not a betrayal of the grief.

Anniversaries, holidays, dates

The body remembers. Anniversaries of the death, birthdays of the person, holidays you used to share your nervous system runs differently on those days, and your glucose can follow. Plan for them. A slightly higher target on the day, food set out in advance, one person who knows it is that day, and the permission to lower the bar without apology.

Philip’s Perspective: How Life Carries On

A personal note from Philip Hall.

There is a story I recently shared in one of my books. I want to tell it here because it’s relates to an important topic often never discussed or shared. Not because I think you need to hear that someone else has suffered. You are suffering enough. I tell it because I know you are wondering, in some quiet part of yourself, how you are supposed to keep going. How the diabetes can fit alongside the rest of life when the rest of life keeps coming.

So here is the story.

I met Kaz in London. She was Australian, on a three-year working visa, and I was working in the city. She was the best thing that had ever happened to me, and then she had to leave. So in August 2000 I quit my job, packed up my life in London, and moved to Sydney to be with her. I was managing Type 1 diabetes through all of it.

The diabetes did not pause for international relocation. It came with me on the plane, and it came with me into the new country, and it kept asking for the same daily attention it had always asked for while I was simultaneously building a new life from scratch.

We got married on Noosa Beach in Queensland in 2007.

Philip Hall with his brother Tim at our wedding
My brother Tim and me, at our wedding.

In 2008 we had our first daughter, Mackenzie.

Our first born
Our first born.

Ten days after Mackenzie was born, my brother took his own life.

Ten days. I was a new father holding a tiny baby, learning how to be a parent, and I was also a brother in the deepest grief I had ever known.

The diabetes did not pause for that either. The blood sugars still needed checking. The insulin still needed giving. The newborn still needed feeding, and the funeral the other side of the world still needed attending, and the body kept asking for the things bodies ask for whether the heart is up to it or not.

Several years later, my mum and dad who lived in London finally got approval to emigrate from the UK to Sydney. They came to be near Kaz, the girls, and me. To finally close the distance that had separated us since I had left.

Not long after they had finally moved over permanently, my mum was diagnosed with a rare form of breast cancer.

Mum and Dad from the UK
Mum and Dad, from the UK.

She did not have long. She used to say that her boys were her world, and now there was one less of us, and she was running out of time with the rest. She died not long after she had emigrated. She came across the world to be close to us, and she got a small handful of years.

Through all of this, I had Type 1 diabetes. Through all of this, the diabetes carried on asking for the same things it had always asked for. The grief did not lower my insulin needs. The funerals did not exempt me from carbohydrate counting. The dark months afterwards did not give me a holiday from blood sugar checks. The condition continued, indifferent, while I tried to hold a family together and a body together at the same time.

I tell you this because you are about to do something similar, even if your version looks nothing like mine.

Life will keep coming at your family while the diabetes is asking for its share of every day. There will be deaths. There will be illnesses. There will be redundancies, divorces, house moves, school moves, betrayals, surprises. There will also be births and weddings and unbearable joy. The diabetes will be there for all of it. It will not pause. It will not give you compassionate leave. It will sit in the corner of every event, asking for the same daily attention.

What I want you to know is this. You can do it anyway.

Not gracefully, all the time. Not without dropping things. Not without nights where the only thing keeping you upright is the fact that the alarm has gone off and a child needs you. But you can do it.

The condition is patient and it is consistent and it is, in a strange way, an anchor through the wildest weather. The numbers ask for the things they ask for, and you give them what they need, and the giving becomes something to do with your hands when the rest of your life is in pieces.

Kaz, Mackenzie, Taylor, Lotte, my dad, my whole family are still here. The diabetes is still here. We have lost people we loved beyond words, and we have kept going, because what other choice was there.

The grief and the management have not been opposed to each other. They have lived in the same house for many years now, and they have learned to share the kitchen.

Whatever life brings to your family, you will keep going. The diabetes will come with you, and so will the love that made you read this book in the first place. That love is the thing that carries the rest.

It carried me. It carried my parents through losing Tim and through Mum’s illness. It will carry you.

Phil

A note on suicide bereavement

If the death you are grieving was a suicide, the experience is its own particular shape. There is the grief that comes with any loss, and there is also a layer underneath the questions, the imagined alternatives, sometimes the anger, sometimes the guilt. Most people who have been through it say it does not lift on the same timeline as other grief.

Specialist support exists. In Australia, StandBy Support After Suicide offers free postvention support: 1300 727 247. In the UK, Survivors of Bereavement by Suicide. In the US, The American Foundation for Suicide Prevention has local groups in many cities. Most countries have an equivalent. Reaching out is part of the work, not a sign you can’t do it alone.

If you are the person with Type 1 in a family touched by suicide, please add this: your safety matters specifically. Make sure your spare insulin and your supplies are not the things you’d reach for in a darker moment. Ask someone you trust to hold the spares. This is normal practice and it isn’t a comment on your strength.

Closing thought

Grief does not negotiate with Type 1, and Type 1 does not negotiate with grief. They live in the same body, the same week, the same kitchen. You do not have to make them get along. You only have to keep showing up for both of them, badly, gently, on the days that are heavy and on the days that are not.

If you have just lost someone, we are sorry. Whatever your Type 1 is doing today, that is also not the most important thing. Today you are allowed to do the minimum, and that is enough.

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