Diabetes: College

______________________________________________________________________

KEY POINTS

• Going away to college is a big step and a big change. Having diabetes can make the move more complex. Planning and being prepared can help you stay active and healthy.
• Before classes start, register with the disabilities group on campus. Check in with the campus health services to see what services and coverage they offer. Check out the food services that you will be using, so that you can plan your meals.
• Always keep a healthy snack and source of quick glucose with you. Keep your supplies handy, and make sure that you eat healthy foods, drink plenty of water, and get enough physical activity and sleep.

______________________________________________________________________

Planning before you leave for college

Going away to college is a big step and a big change. Having diabetes can make the move more complex. Planning and being prepared can help you stay active and healthy.

Discuss with your healthcare provider or certified diabetes educator:

• Where and when you are going to college:
  • Any vaccines you need
  • If you are going outside the US, what equipment and supplies you will need
• How to plan for your care:
  • Discuss whether you need to transfer your care to a healthcare provider in your college town.
  • Discuss how and when to use the student health services. You can check with student health services to see what services and coverage they offer, and how the healthcare providers there can work with your regular healthcare provider.
  • Discuss when you should call your diabetes care team.
  • Get copies of your health records and medication list to have with you.
  • Get copies of your insurance information.
• What types of activities you will be doing and how they may be different than what you do now
• How often to check your blood glucose (sugar) levels and if you should check for urine ketones
• How to adjust your medicine schedule when you have changes in your daily routine
• Your diabetes action plan and your sick day rules
• What birth control methods are right for you, if you choose to be sexually active
• Alcohol and recreational drug use, if any

Talking about my diabetes

You should tell the people who will be around you that you have diabetes, including:

• Your roommates
• The head resident in your dorm
• Friends and people that you are dating
• Student health services staff

Include information such as:

• What medicines you take
• Where you keep your supplies
• How your meal plan works
• What symptoms of high or low blood glucose look like
• How to use a glucagon kit
• When to call for emergency help

Before classes start, register with the disabilities group on campus. Though many people with diabetes don’t consider having diabetes a disability, registering will allow you more choices for carrying food, snacks, and medicines that you need.

Check out the food services that you will be using. Request nutritional information on foods that will be available to you, so that you can plan your meals. Talk to the food service manager or dietitian if you have concerns.

Moving to college

• Make a checklist of the things you need to take.
• Stock 1-3 months of supplies and know where to get supplies and insulin locally, including getting and disposing of a used needle (sharps) container. Plan how you will pick up new supplies or arrange regular deliveries. Plan for:
  • Who will order your supplies
  • How and where the supplies and medicines will be delivered
  • How payment will be handled
• Get a glucagon kit if you take insulin. Tape your glucagon kit to your bed or wall in your room.
• Keep your healthcare provider’s name and phone number along with other emergency contacts information with you.
• Wear a medical alert bracelet or necklace that says you have diabetes. If you take insulin, it should say that on the alert. If you are unconscious, this tells emergency healthcare providers that you have diabetes and need special care.
• If you use an insulin pump or continuous glucose monitor (CGM), take extra batteries, and have a backup plan in case your devices fail.
• Get some small bags to carry supplies with you during the day including a small insulated bag for insulin if needed.

Other things to keep in mind

• Plan scheduled time for physical activity.
• Try to get at least 7 to 9 hours of sleep each night. If you regularly have trouble getting enough sleep, talk to your healthcare provider.
• Eat a variety of healthy foods and snacks, and drink plenty of water. Be sure to include lean protein, complex carbohydrates (carbs) such as whole grain pastas, breads, and cereals, fresh fruits and vegetables, nuts, seeds, healthy plant oils such as olive oil, and foods with high fiber. Carry healthy snacks and a water bottle with you.
• Always keep a healthy snack and source of quick glucose with you. Always carry extra glucose tablets or gels to treat symptoms of low blood glucose in a pocket or purse so they can be easy to reach.
• If you take insulin, make sure you have a refrigerator in your room for storage. Check the temperature to ensure that it stays at about 36 to 46 degrees F (2 to 8 degrees C). Have a safe box to store needles and other supplies.

Staying safe

College comes with big changes in activity levels for school, work, and play. You will meet many new people who may have lives and ideas much different from yours. You may need to adjust to changes with the foods you eat, when you sleep, and how you stay physically active. Also, you may be offered alcohol and recreational drugs that you may not have seen before college.

• If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Drinking alcohol can affect your blood glucose level. Being intoxicated (drunk) can hide the symptoms of hypoglycemia.
  • Don’t drink alcohol on an empty stomach.
  • Be sure to eat healthy snacks while drinking alcohol, especially if you are dancing or involved in other physical activities that use energy.
  • Stay hydrated by drinking enough water in between alcoholic drinks.
  • Avoid drink mixers that contain large amounts of sugar.
• Recreational drug use presents safety issues for any user but even more so when you have diabetes. Anything that changes your ability to judge how you feel can be dangerous. Also, any substance you take can interact with and affect the medicines you already take for your diabetes.
• High blood glucose can slow or limit your body’s ability to fight infections.
  • Avoid infections by washing your hands frequently and avoiding sick people as much as possible.
  • Any infection, including sexually transmitted diseases (STDs) or sexually transmitted infections (STIs), are a concern for someone with diabetes. Practice safe sex:
    • Use latex or polyurethane condoms the right way during foreplay and every time you have vaginal, oral, or anal sex until you are in a committed monogamous relationship or ready to start a family.
    • Have just 1 sexual partner who is not sexually active with anyone else and who will use protection every time you have sex.
    • If you have had sex without a condom and are worried that you could be pregnant or have an infection, see your healthcare provider. Having a healthy pregnancy and baby is possible for a woman with diabetes, but you need extra care before you get pregnant and during the pregnancy.

Talk to your healthcare provider about these vaccines that can prevent infections:

• Hepatitis B vaccine (Hep B) vaccine. Hepatitis B is a liver infection caused by a virus. You can get this infection by coming in contact with the blood or other body fluids of someone who is infected with the virus. Hepatitis B is often spread by having sex with or sharing needles with someone who has the infection.
• Hepatitis A vaccine. A shot to protect against hepatitis A is also available for people at risk such as men who have sex with men, using drugs and sharing equipment, and traveling to areas of the world with a high hepatitis A infection rate.
• Human papillomavirus (HPV) vaccine. HPV is a virus that can cause cancer of the mouth, anus, penis, or cervix, as well as genital warts. The HPV vaccine is approved for females and males age 9 to 45 years old. It’s best to get the HPV vaccine before you have sex for the first time.
• Meningococcal (MCV4) vaccine. Meningococcal disease can cause severe infections of the lining of the brain and spinal cord or the bloodstream. Two doses of MCV4 are recommended, the first at age 11 and then before moving into college dorms.
• Influenza (flu) vaccine. Flu is caused by a virus that is easily spread from person to person. It causes fever, headaches, body aches, sore throat, and cough. Get a flu shot every year in the fall when it becomes available.
• COVID-19 is caused by a virus that is easily spread from person to person. Vaccines are being used to protect against COVID-19. Get the vaccine to help prevent getting COVID-19. The vaccine itself will not give you COVID-19, and you will be less sick if you do get COVID-19 after getting the vaccine.

Ask your healthcare provider about any other vaccines you may need.

Mental and emotional health

Going to college and living away from home can be stressful. Be aware of your stress levels and notice signs of depression or anxiety such as:

• Feeling angry
• Mood or behavior changes
• Having problems with school or work
• Withdrawing from family members and friends
• Feeling sad, hopeless, and uninterested in daily life
• Forgetting things or having trouble concentrating
• Sleeping a lot more, have trouble falling asleep at night, or waking up at night and not being able to get back to sleep
• Making unhealthy food choices, or using alcohol, drugs, or food to feel better
• Having trouble managing finances

Contact your student health center or your healthcare provider if you have signs of depression or anxiety.

For more information, contact:

• The Diatribe Foundation
  https://diatribe.org/tips-heading-college-type-1-diabetes-cdn
• The College Diabetes Network
  https://collegediabetesnetwork.org/