Natalie Balmain was just three months shy of her 21st birthday when she received a diagnosis of type 1 diabetes. Now, 10 years later, Balmain is a communications officer with the United Kingdom’s National Health Service, as well as a part-time model and actress. And in what spare time she has, she’s also the founder of a very unique fashion line — one dedicated to women living with type 1 diabetes, appropriately named Type 1 Clothing.

Balmain’s work has attracted attention worldwide, even garnering a tweet from Chelsea Clinton. We caught up with her to talk about her diabetes journey, why she started her fashion line, and why we need to change the way we approach chronic conditions like type 1 diabetes.

What’s it like being in your early 20s and suddenly having to worry about managing a condition like diabetes?

I think being diagnosed with type 1 diabetes at any age is a huge emotional trauma, and that is why so many diabetics are also then diagnosed with depression. But for me, I certainly found being diagnosed at 20 very hard. I was just entering adulthood, I was used to being carefree and not having to worry too much about what I consumed, or how I lived.

Then, suddenly, I was thrown into this world where every day I basically held my life in my own hands. You can easily die from your blood sugars being too low, or indeed if they are too high for too long. I think I basically had a nervous breakdown and I was depressed for a few years after my diagnosis.

Do you feel like there’s a general inclination for people to ‘hide’ their chronic conditions, whatever they may be? What do you think feeds that, and how can we combat it?

While there are absolutely some people out there who wear their conditions with pride (and why not?!), I do think that for most people, myself included, it’s very easy to feel self-conscious about having a chronic condition.

Personally, I think that’s largely in part to the many misconceptions that are out there about various illnesses. You just don’t know how people will react. So, I’m a firm believer in promoting education and awareness — not only because it can help people feel more comfortable with their conditions, but because it can also potentially save lives.

What was the ‘lightbulb moment’ that inspired you to create your own line of clothing?

I think there was a slow, subconscious buildup to a lightbulb moment when I had the idea. I remember sitting in my living room with my flatmate at the time, and there was a little hole in the side of my trousers in the seam. I’d been meaning to fix them, but I just lounged in the house in them, so I hadn’t.

I did my injection through the little hole and I thought: Actually, this little flaw works for me! And then I looked to see if any clothes like that had been made, with little openings for diabetics, and there wasn’t anything. So, I started drawing. I’d always drawn fashion since I was a teenager, but never done anything with it. But these ideas just started coming and I instantly got really excited.

A lot of your designs feature multiple injection access points — how many times a day does the average person with diabetes have to take an insulin injection?

Well, every diabetic is different, but I personally do something called “carbohydrate counting,” where I try to best mimic the body’s natural insulin production. I take twice daily injections of a slow-acting background insulin, and then take fast-acting insulin every time I eat or drink anything with carbohydrates. That’s something people really don’t understand — especially when you tell them fruit has carbs! So, I can easily take six or more injections a day.

Then you have to think about the fact that you have to move your injection site around every time to avoid creating scar tissue. So if you inject six times a day, you need six good areas of your best fat bits to inject into, which is often around your stomach, buttocks, and legs for a lot of people. That’s when it gets difficult — if you are in a restaurant and you need to inject for a meal, how do you do that without pulling your trousers down in public?

What’s one situation where you thought, ‘I really wish my outfit was more diabetes-friendly’?

I’m a big fan of jumpsuits — I love wearing them on a night out with a pair of heels! Like most women, when I want to make myself feel good (and trust me, you need that sometimes when you live with a chronic condition), I like to get dressed up and do my hair and makeup, and go out with my girlfriends.

One New Year’s Eve I was out with my friends wearing a jumpsuit and it was a great night, but very busy. It took us ages to get our drinks and get a space, so I thought, “I’ll just have two drinks and then go and take my injection.” Because I was wearing a jumpsuit, I would need to go to the toilet and pull it all the way down to access my stomach to do it.

But the cocktails I had were quite sugary and I felt hot from my high blood sugars, so I suddenly wanted to rush to get in the toilet, and there was a huge queue. By the time any toilet was free I took it, and unfortunately this happened to be the toilet next to someone being sick. I had to do my injection there, but it was just the worst place to have to do it.

What other practical considerations does your clothing make for the women who wear it?

One of the things that made the biggest difference in my life was when I was introduced to my online diabetic support group on Facebook. And because of that, I have a lot of friends who I know are on insulin pumps. And I felt their pain, too. It’s so hard to find a nice dress that can hold an insulin pump, and even then you still have to have your wires on show.

So I decided to also create special pockets in my designs that had punched holes in the inner layer, allowing you to feed the tubing through your clothes. And on dresses, I hid them with frills or peplums to avoid visible bulges.

What have been the main challenges in developing this fashion line?

The main challenge for me in developing this line has been the fact that I didn’t want to borrow money in case it didn’t come to anything, so I self-funded the project entirely, including paying for my patent application.

So I’ve continued to work full time alongside doing this to pay for it all. It’s been a long two years of work, and it’s definitely been hard not to be able to go out for dinner with friends, or buy clothes, or do anything, but I really believed in what I was doing, thanks to the support of a few friends. If I didn’t have that belief I probably would have given up a hundred times!

Who’s an inspiring figure to you in the diabetes community?

An inspiring figure in the diabetes community, to me, is my friend Carrie Hetherington. She is the person who found me on social media and introduced me to the online support group that came to be of so much comfort to me. She is a seasoned diabetes speaker and teacher, and has even written a kids’ book with a diabetic hero, “Little Lisette the Diabetic Deep Sea Diver.” She is inspiring!

What’s one piece of advice you’d give to someone newly diagnosed with type 1 diabetes?

If I could give one piece of advice to someone newly diagnosed with type 1, it would be to take each day at a time, and to find a support group of other T1s — whether that be in person or online — as soon as you can.

You can check out Balmain’s designs for Type 1 Clothing, which are made-to-order, on Instagram, Twitter, and Facebook

Kareem Yasin is a writer and editor at Healthline. Outside of health and wellness, he is active in conversations about inclusivity in mainstream media, his homeland of Cyprus, and the Spice Girls. Reach him on Twitter or Instagram.