The back-to-school season is upon us. My favorite time of year! If this is going to be your first year of college with T1D, or maybe you’ve been in college with T1D for a while now, but are looking for some great tips, then this article is for you!
I got diagnosed with type 1 diabetes the summer going into my Junior year of college. At the time (way back in 2008) there was no information or blogs or anything out there about how to navigate college with T1D. In fact, there was very little information about ANYTHING related to T1D. Everything I learned was through a lot of trial and error…a lot. By the time I perfected it I was walking across the stage for my diploma. But hopefully you won’t have as many trials and errors, since it seems like you found this article at the perfect time! Here are some tips & tricks that got me through college with T1D.
7 Tips for Heading to College with T1D
The first tip on this list is something that I never knew existed until after I graduated college. If I would have known about it, I most certainly would have used it. That tip is…
1. Contact the University’s Office of Disability Services
I know we don’t like to think of T1D as a disability, but in the eyes of the ADA (American’s with Disabilities Act) it is, and for good reason. For two years I snuck snacks into class, trying to discretely eat them when I felt a low come on. Sometimes this “low” was just exam nerves and I was in fact treating an already high BG with more sugar – no bueno – how well do you think I did on that exam when my BG was in the 400’s?
In hindsight, I can see how extra help or certain accommodations would have made my life at college a lot easier. For example, If I was allowed snacks (even in a food-prohibited class room) I could treat a low without having to leave and miss important information. If my teachers were made aware of my condition, I could check my BG without the fear of being called out. If my BG was too low and I couldn’t finish a test, I could retake it at a later time/day.
The ADA is what makes sure people with T1D have the rights/accommodations they need to live their lives. Diabetes is challenging, and college takes it to a whole new level. It’s important to know what services can help make your life with T1D a little easier.
Your college is legally responsible for accommodating your diabetes needs.
Some of these needs include:
- Allowing you to retake an exam or assignment that was completed under the influence of a high or low blood sugar.
- Allowing you to reschedule an exam in cases of hyper/hypoglycemia
- Allowing you to bring in food & drinks into the classroom (even if not permitted) in case of a low.
- Allowing you to check your devices without being called out. Like, “Mrs.Martin, phones away now.”
- Allowed breaks during class and exams (even if not permitted) to treat hyper/hypoglycemia
- Early registration for classes, housing, and meal plans.
- Special room accommodations (like refrigerators for food and insulin)
- Access to cafeteria nutritional information
- Access to dorms with cafeterias (or those near by)
- Leniency in class attendance policies to accommodate for hyper/hypoglycemia episodes
As soon as you arrive on campus (or before, if you want to beat the rush) Contact the University’s Office of Disability Services. Not sure who/where that is? Reach out to Health Services on your campus and they can point you in the right direction. Keep in mind, most Universities will ask for documentation, which may mean proof of prescriptions, a Doctor’s Letter, etc..
Learn more about your rights as a college student with T1D here.
2. Switch to a Local Endo
Although my university was only an hour away from home I ended up getting a new endo. I’ll admit, I wasn’t happy with my diabetes team back home which made the switch a VERY easy decision. But I also got really sick of taking 3 hours out of my day for a 30min check-up appointment.
Of course, if you have a totally kick-ass team, and you plan on moving back home after graduation, then I get it! Good Endo’s are very hard to find.
3. Switch to a Local Pharmacy
Being able to run 5 minutes down the street to pick up an extra vial of insulin because yours smashed on the dorm floor is so much better than having to drive a hour (or more) to your hometown pharmacy because your insulin vial smashed on the dorm floor. Accidents happen, prescriptions get lost, or go bad, or break. Having a local pharmacy will save you a lot of time (and energy!).
How do you switch pharmacies? Just call your doctor and let them know where to send your new scripts – it’s that easy!
4. College Food is Not Your Friend (cafeteria, fast food, etc)
I don’t know about you, but I can NEVER get bolusing right when I’m eating food that someone else made…and that’s all the first two years of college are (at least it was for me). Now unless your university has kitchens in underclassmen dorms, you’re about to learn real quickly how much sugar is added to cafeteria food. Like my college putting high-fructose corn syrup in chicken noodle soup?! Who does that?!
Here is where help from your university’s Office of Disability Services comes into play. You may be able to get a dorm with a kitchen so that you’re not stuck eating cafeteria food that can spike or severely drop your blood sugar levels. (Like eating a cake that you didn’t know was made with Splenda).
If you can’t finagle a dorm room with a kitchen, then look into buying a single burner plate and some pots and pans. Your university will be able to provide a mini fridge so you keep your insulin but you can also use this to store some fresh food so you don’t have to hit up the grocery store every time you want to eat.
5. Parties & Alcohol
In my opinion, the biggest danger with alcohol is low blood sugar. When you drink, your liver is more concerned with cleansing alcohol from your blood stream than it is creating/releasing glucose in case of a low.
This means that even an injection of emergency glucagon will not work until your liver has finished its alcohol-cleansing process.
Why? Because glucagon is a hormone that tells your liver to release it’s glucose stores into the bloodstream. Glucagon is not glucose. So if you’ve been drinking, emergency glucagon will not work.
Orally ingesting glucose will work to bring up your blood sugar levels, since that involves no work from liver, just your mouth :), but alcohol has a funny way of impairing judgement so you may not realize the urgency or be as quick to correct (in my personal experience).
The other aspect to think about is drunk math…
Diabetes is math. Have you ever tried to sit through math class drunk? Me neither, but I imagine it would be pretty hard and I would not put any faith in my answers.
Even with an insulin pump (which does most of the math for you), good diabetes management is more than just numbers, it’s also intuition and just knowing yourself and your body. Intuition and better judgement take a back seat when drinking, so it’s important to pay attention to this stuff.
I didn’t have a pump in college and was always forgetting what time and how much insulin I gave myself. I was always over bolusing & under bolusing because I wasn’t in the right frame of mind. Looking back, I don’t think I realized how much danger I was putting myself in.
Low Carb Drinks
The less insulin you have to give yourself the less room for error. This is why I stuck to low carbs drinks like my favorite: vodka, soda water, and a lime.
Tell Your Friends
I can’t stress how important it is to let your friends know you have T1D. Being low often resembles being drunk and when you’re at a party suffering from a bad low people may assume you’re just hammered. It will help to have friends around that will double check with you to make sure everything is okay.
Bonus advice: Check your blood sugar often or get a CGM.
Bonus advice #2: Dancing drops blood sugar like it’s hott! So be aware of this and check often!
6. Contacts (safe person to call for an emergency)
For most of your time at college you’ll be surrounded by people; in the dorms, at parties, and in class. But there are times when you’ll be alone. Your roommate might leave for the weekend, or you might decide to stay in one night while everyone goes out. Either way, you’ll be alone at one point or another, and being low and alone is something my nightmares are made of.
If being low and alone doesn’t scare you, skip on down to the next tip. If it does, keep reading..
So what do you do when you’re low and alone, besides panicking?
Make a contacts page (in your phone). I have a whole screen dedicated to people that live both locally and a ways away that I can call in case of a low blood sugar. Most of the time I just need someone to talk to because I’m scared, but in the case that it becomes dangerous I can have that person come over and check on me. Or if they aren’t local, at least they can talk on the phone with me and if the line cuts out or I stop answering, they know to call 911 and give them my location.
7. Last Tid-Bits
Of course you’ll want to stock up on supplies & snacks, tell your roommate(s) about your T1D, and have my sick day toolkit on hand, but other than that have fun! College is a great place to stretch your wings and gain a some freedom and independence. Be smart about your choices and you’ll do great!
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