Are you going off to college to get your first taste of independence and semi-adulting? Perhaps you have already been at college for a month or so. How are you managing your diabetes? Are/were you equipped for all of the challenges that come with leaving home and starting a new chapter of your life? Did you know there would be so many parties?
Each year, about 2.3 million freshmen enroll in institutes of higher education in the U.S. About 7,700 of these freshmen, based on the current prevalence, have Type 1 diabetes1. These students, in addition to adjusting to dorm and campus life, do not have the support of their parents and/or someone that can remind them when they need to self-manage their diabetes. They are faced with many choices, some of which may be dangerous for them. There are extra challenges and responsibilities to think of as a college student with diabetes.
Sofia’s concern, when she contacted the diabetes council, was exactly this. As a college freshman at the University of Maryland, she was having trouble managing her diabetes, along with her hectic schedule. She wanted to get some help learning how to manage life in college with diabetes. She wanted to be successful in college, so that she could pursue a career in the medical field.
Being the parent of a college student with diabetes
I am currently the parent of a rising sophomore at Appalachian State University. It was not so long ago when we drove her up the mountain, two cars loaded down, headed for Boone, NC with the beautiful Blue Ridge Mountains as the backdrop. Tensions were high. Excitement was high too. She and I were venturing high up the mountain diving into the unknown.
I had a whole list of worries back then. I still have a long list of things to think about, plan for, (and if I let myself) worry about. My daughter, however, is not a college student with diabetes. I can only imagine and speculate what it must be like to be the parent of a college student with diabetes. As a Certified Diabetes Educator, I am aware of all the items on their list of things to prepare for, and the diabetes management challenges that they face.
For the most part, I have no idea what the level of mental anguish that this could cause parents and students. My daughter thinks she has a lot of stress, with her class load and part time job. She is in a Christian sorority, and involved in leadership (Appalcorps). If she had all that a college student with diabetes has on their plate, she might have a legitimate reason to complain.
I do, however, know what it is like to be in college. Back in the 1980’s, when I was in college, I remember “pulling all-nighters” writing psychology labs, attending concerts and parties, hectic class schedules, and working nights as a waitress. If I had Type 1 diabetes, with the way I was taking care of my body, I might have had a hard time to make it through freshman year.
I remember my daughter calling me after the first few weeks of freshman year – they were in the middle of rushing for sororities. Her roommate was rushing a sorority that did not mind alcohol presence at parties. My daughter was rushing a Christian Sorority that did not drink or use drugs. My daughter called me to say that there was a drunken freshman standing at the top of the hill screaming. He was rushing one of the fraternities, and was doing this in his underwear.Things can get quite crazy on a college campus. Think “Animal House,” and add in technology.
It does not take but one time to figure out what drinking too much alcohol on an empty stomach will do to you. If you do not know already, perhaps you should take my word for it and not try it.
Difficulties of being a college student with diabetes
For the college student with diabetes, there is so much more to think about than for the student without diabetes. There is so much planning that you must do. You must always:
- think ahead,
- make sure to take all of your supplies with you,
- organize meal plans
- stay active.
- if you are an insulin pumper, you need back-up insulin.
- you always need Quick-carbohydrate snacks for a low.
Pre-planning for living the college life
If you are preparing to go off to college, planning by following some specific steps can help you to be better prepared for college life and dormitory living with diabetes.
There are many different scholarships specifically available to students with diabetes or to general disabilities that one can apply to. Speak with the financial aid office about scholarship opportunities, and scholarships that may be school-specific. You may also consult our scholarship guide.
Sharing a room with a roommate?
Most likely during your first year of college, you will be living with one or more than one people. Some universities have suites that share a kitchen and bathroom, where four students share the house together. Some dormitories are co-educational, meaning they house both males and females.
Do you get to pick your roommate, or do you get placed in a lottery for a roommate? In either case, you will want to make sure to find out who your roommate will be in order to communicate with her and her family about your diabetes before the move-in day. Communication between your family, you and your roommate, and other suitemates can make the difference between a rocky and a smooth transition into college life.
During a meeting with your roommate and their family, your parents should get the telephone numbers for your roommates, suitemates, and resident directors in case of an emergency. They can give special instructions, like where your glucagon pen or quick carbohydrates will be located in case of a low blood sugar.
They can instruct dorm folks on how to use the glucagon pen, or treat with the right amount and right kind of carbohydrates. This will go a long way in helping your parents to adjust to their empty nest syndrome. It will help to alleviate their fears related to your going off to college with diabetes.
Planning for snacks in your dorm room and back up snacks in your resident director’s apartment
Most dormitories have a resident director. This person could be a graduate student, who lives in and supervises the dormitory. This person is your go-to person for questions or problems in the dorm. This person could be the backup person who will have a stash of quick-acting carbohydrates for you to have if the need arises, and you do not have anything.
Let’s say your suitemate raided your stash of carbohydrates during a late-night study binge. Hopefully, you will have discussed the need for you to keep your carbohydrates to yourself ahead of time to prevent this! It is helpful to discuss your diagnosis with everyone who you come into contact with in your dorm at college (more on that below).
Planning for needed supplies, and extras!
You should plan to take at least 2 glucometers and all needed supplies with you to college.
You should have:
- one in your dorm room,
- and one in your book bag.
- it is a good idea to keep a third one in your vehicle if you are taking a car to college.
Arrange for insulin syringes, in case of a pump failure if you use an insulin pump.
Take extra pump sets, too. When you exercise, you may need more sets if you sweat, and your pump set tends to curl off. Take some extra adhesive for saving a pump site until a regular change is needed.
The following is a quote from David C. Mellinger, “Preparing Students with Diabetes for Life in College.”
“Before leaving for college, students need to ensure that they have all of the supplies needed to manage their diabetes while at school. Although most remember to take their blood glucose meter, monitoring strips, alcohol wipes, insulin syringes (or pump), and insulin, many will forget items that they can easily find at home (e.g., sharps container) or may not have considered (e.g., urine ketone test strips). Other items to pack include ready sources of glucose (such as small cans of juice and glucose tablets), glucose gel, Medic Alert identification, a copy of important contact phone numbers, and their insurance card.”
Diabetes supply list for college
In addition to the long supply list that college students already have, college students with diabetes have another lengthy list of things to gather. Let’s work on a comprehensive list of what to take with you when you go off to college with diabetes…
- Plastic bags with extra pump sets if you use an insulin pump
- Plastic containers for carrying food or insulin
- Ice packs that you can remove from the dorm freezer to put in plastic containers or lunch boxes
- At least 2 glucometers
- 3-4 lancing pens or devices
- A generous supply of bottles of glucometer strips
- A generous supply of alcohol pads
- A generous supply of lancing needles
- A sharps container
- A generous supply of insulin needles
- A generous supply of insulin
- A generous supply of bottled water
- A sick day box
- A lunchbox with zipper and lock
- A supply bag for carrying diabetes supplies
- Snacks and grocery list items
- Birth control pills, condoms, or other method if needed
- Other medications if required
- All current medical records
- All emergency numbers for back home
- Medical ID, bracelet, wallet card, or necklace
- Urine ketone testing strips
- A generous supply of glucose tablets
- A generous supply of juice
- Glucose gel
- Medical insurance card
- Other items that you may use in your diabetes care as needed
- Milk to prevent an overnight low blood sugar
- Generous amounts of 15 gram carbohydrate snacks of choice
Touring the dining hall and other facilities
These days, colleges have a variety of meal choices. They range from the conventional dining hall, to chain and local restaurants on campus that take the meal card students purchase. Appalachian State University, for example, has a McAllister’s Deli, a sushi restaurant, a Chic Filet, a Mexican restaurant, and several other choices – all available using the student meal card.
This variety provides for a myriad of dietary choices, good and bad. If possible, it may be useful to tour the college with a nutritionist from the student health center. This way, you can learn what your best options may be, and the nutritionist can help you navigate the menus.
If a nutritionist is not available, tour with your parents, and pick up menus and nutritional information from the dining hall, and other restaurants. You can have these menus handy to better plan out your eating strategy.
Planning for exercise on campus
You will want to get some regular exercise on campus to help your body use the insulin you inject or get through your insulin pump better. Tour the campus exercise options, as well as the surrounding recreational activities. In Boone, NC, where my daughter is, for example, they have snow skiing, hiking, tubing, and all sorts of outdoor activities to take advantage of.
Check out the campus gyms, free yoga, Pilates, and other exercise classes, walking groups, and the likes. There is also plenty of walking to do to get from class to class if you go to a larger university. Take everything into consideration to prepare for your activity ahead of time.
Always remember to plan for excursions off campus, and take all of your needed diabetes supplies and insulin with you. If you are prepared, you will not ruin your trip with an unwanted low blood sugar. Always remember to check your blood sugar before exercise, and eat a quick-acting carbohydrate snack. You will need 15 grams of carbohydrates for 30-45 minutes of exercise, and 30 grams for an hour or longer.
Getting some exercise reduces stress, thereby lowering blood sugars overall. So get out there!
If you are an athlete with diabetes in college, refer to our new blog article on how to manage exercise when you are an athlete with diabetes.
Plan a trip to the student health center
Visit the student health center during the summer, before school starts. Meet with your care team, and review your diabetes plan. Be sure to give staff a copy of your medical records. Take away any tips that they may have, including making sure to have plenty of all of your supplies, including medications.
Set up an appointment for soon after the school year starts for your quarterly A1C and check-up. Get all needed emergency, urgent care (including nights, weekends, and holiday’s numbers). You may need to call the staff if you have moderate to large ketones in your urine with high blood sugars. Get the pharmacy phone numbers from the staff, and start to build a rapport with your new college health care team.
Talk with your healthcare providers about a plan in case you have an insulin pump failure if you use one. Most of the time, you have many options for communicating with your campus health center, including phone calls, email, and texting. Some nowadays even have tele-health, and can evaluate you via computer.
Find out where you will get medications that you will need at college. Since most prescriptions are for three months, you may need to arrange to get your medications through the school pharmacy, or an off-campus pharmacy. Getting this done ahead of time may save you some problems with getting needed insulin and medications during the college year.
Homesickness and empty nest
Many freshmen at college report that they get home-sick. Stay in touch with your parents, and share your experiences to make the transition easier for the both of you. Send them a quick text, or plan to give them a call once a week. Remember that they are dealing with fears both related to your diabetes and how you are managing in college.
If you use a continuous glucose monitor, it is okay to let your mom or dad in the middle of the night if you get a low. That way they know you are up, and treating it. They will rest easy.
It may be helpful to send your mom or dad a quick run-down of your numbers when you get to college, so that they can see that their children are doing well. Remember that your parents may be dealing with the empty nest syndrome after you leave. Though they are glad they are reaping the benefits of their hard work as parents by seeing you go off to school, hey may be homesick for you to come home, too.
Take some things with you for your dorm room that remind you of home, like a favorite pillow or a picture of your friends from high school. Staying connected with your past will help you to move into your future. After all, it is a part of you!
Planning for travel to and from college
Remember to check your blood sugar 30 minutes before you leave to drive to college or home from college. Every two hours, you should stop and check your blood sugars. Carry an extra glucometer, strips, lancing device, lancets, and alcohol pads. Make sure to carry your quick acting carbohydrates in the car with you. You can carry a small lunch cooler if needed, for insulin or food items that need to be kept cold.
If you use a glucagon pen, you should have one stashed somewhere in the vehicle at all times.
If you have an iPhone, set the emergency alert on it. Carry a medical ID card in your wallet, and wear a bracelet or necklace that let others know you have diabetes.
Skipped meals, parties with friends, and alcohol
Do not count on your meals to be always on time. If you are out with friends, they might try to ditch the meal plans and go straight to the party. At the party there will be alcohol. If a college student with diabetes drinks alcohol on an empty stomach, they can have a low blood sugar.
This is a dangerous situation, as the low blood sugar may quickly worsen, warranting an emergency. But because the college student with diabetes is “sleeping it off”, no one will try to wake them up.
Share your diagnosis with those in your dormitory and professors ahead of time
This is why it is so important for the college student with diabetes to have “the talk” about their diagnosis. They should talk to everyone in their dormitory that needs to know, including any suite mates. The roommate, especially, needs to know what to do in the case of a low or high blood sugar, and where to find emergency medicines, such as a glucagon pen or insulin.
The resident director of the dormitory hall needs to be made aware of the diagnosis. It is helpful to provide all of the people that will be involved in the said college student’s life with mini training sessions. You should go over signs and symptoms of low and high blood sugar, the treatment of each symptom, and where treatment carbohydrates or medicines will be located in the event of a diabetes emergency.2
Professors may only need to be given the signs and symptoms of hypoglycemia and hyperglycemia sheets above, a mini run-down of any problems that might occur in the classroom, and how best to deal with them. For example, if you had a low blood sugar, or if you needed to make extra trip to the bathroom, the professor will recognize such needs.
If you get a chance to attend a freshman orientation weekend, where you get to stay in your dormitory, possibly even with your roommate, you should do it!!! You will familiarize yourself with the layout, see the facilities, and your parents can usually tour the dormitory as well. This helps them to cope, also!
Join a College Diabetes Network chapter for support and awareness
Some colleges and universities have a College Diabetes Network chapter that you can join. There, you will meet others who have diabetes, and gain a support network of other college students with diabetes. You can participate in fundraisers and awareness activities, or even run for office. Link to their website at: www.collegediabetesnetwork.org. There you will find a wealth of information related to diabetes in the college setting.
If you experience discrimination as a college student with diabetes
Unfortunately, even today, people with diabetes experience discrimination in a variety of situations at work and at school. If you feel that you are being discriminated against while attending college because of your diabetes, the College Diabetes Network has resources to help you.3
Other issues that may come up while you are at college with diabetes
Dating at college with diabetes may bring with it social challenges, like when is it best to tell your date about your diabetes? When should you have sex, and what kind of birth control will you use if you do? When you have diabetes, it is best to use contraception when you are under good control of your diabetes. College is a time for you to find yourself, and prepare for life. Talk with your campus health center about birth control options if you need them.
Over to you
We invite all up-and-coming and current college students with diabetes (and their parents) to share your comments with us in the comments section below. If you have any neat tips to share that we did not mention, we would love to hear from you! Here at The Diabetes Council, we strive to provide you with most up to date and useful information. We wish to provide you with articles that enhance your life, and help you to live better with diabetes. We would love to hear how we are doing with our mission below, as well.
Be sure to look for our upcoming book, Abbey at Appalachian – A Diary about Going to College with Type 1 Diabetes, written by yours truly, with wonderful illustrations by Valeriia. It is coming out soon, and we hope it will help college students with diabetes everywhere find their way down the path of college success. Through the eyes of Abbey, a freshman at Appalachian State University in Boone, NC, with Type 1 diabetes, we get a glimpse of what her college life is like, and of the challenges she must face daily as a college student with diabetes. So stay tuned!!!