How Students Can Stay Safe, Healthy & Happy on Campus
According to the Centers for Disease Control and Prevention (CDC), over 30 million people—nearly 10 percent of the population—are currently living with diabetes. Among them are many college students, who may find that managing diabetes while attending school is a tough task. Living a full life with diabetes is more than possible, though, and this guide aims to ease the burden. Here students can find information on what diabetes entails, what to expect from living with it during college and what accommodations are available.
Understanding Diabetes in College
The key to managing diabetes is understanding how the condition affects the body, what the causes are and what treatments are available. Here’s a quick primer:
How many college students have diabetes?
In addition to the 30 million U.S. residents who already have diabetes, another 84 million have pre-diabetes, indicating they’re at risk for developing Type 2 diabetes within five years. College students are not immune in these statistics.
In 2015, 193,000 people aged 20 or under were diagnosed with diabetes.
Type 1 diabetes is actually more common than Type 2 in people under age 20, but as the incidence of Type 2 diabetes continues to rise among younger people, thousands of students will be diagnosed with Type 2 or pre-diabetes during their college years.
What is diabetes?
Diabetes is a condition that results in too much glucose in the blood. It takes one of two forms:
An autoimmune disease in which the pancreas does not produce any insulin. Without insulin, the body can’t make use of the sugars in food, even though those sugars are essential in maintaining the body. People with Type 1 diabetes must undergo insulin therapy to receive the insulin their body doesn’t make. Type 1 diabetes is rather rare, affecting only about five percent of those with a diabetes diagnosis.
Far more common, affecting about 95 percent of those with the condition. In these cases, the body does make insulin. The problem arises because either the body does not produce enough insulin, or because it lacks insulin sensitivity and therefore doesn’t use it appropriately. Type 2 diabetes is often triggered or exacerbated by living a sedentary lifestyle, being overweight, or eating a diet high in processed foods and empty carbohydrates.
In either type, the complications from high blood sugar are the same. Over time, they can include serious problems including:
Impaired circulation, and more
Diabetes is manageable, but it’s important to recognize the symptoms, which can include:
Extreme hunger and/or thirst
Breath that smells very sweet
Unexplained weight loss
Nausea and vomiting
Other signs that might occur over a longer period of time include:
Cuts or sores that heal slowly
Pain or numbness in the feet or legs
With Type 1 diabetes, symptoms usually show up within a matter of days or weeks and quickly become severe. With Type 2, the onset of symptoms is more gradual, making them harder to spot. However, getting a regular physical with diabetes screening can identify the problem.
The best diabetes treatment depends upon the individual and their personal health situation, and there’s no single course of therapy; however, patients can expect to undergo a treatment such as these:
Those with Type 1 diabetes require supplementary insulin delivered via an injection. This can be through a preloaded insulin “pen” that can be set to deliver the proper amount; a vial and syringe in which the user fills the syringe with the appropriate amount; or an insulin pump, which provides a steady amount of insulin throughout the day.
Improved diet and exercise:
An appropriate diet and exercise regimen is still the gold standard of treatment for type 2 diabetes. When more is needed, insulin therapy may be required.
Some medications also work in conjunction with the insulin the body still produces, boosting insulin sensitivity and resulting in lower blood sugar levels.
Resources on campus
Students dealing with diabetes need all the support they can get. Fortunately, there are usually on-campus resources students can take advantage of.
College health center or clinic
This is a vital resource for students with diabetes. The staff there can help students track their glucose levels, offer the basic tests required, and prescribe necessary medications to help keep blood sugar under control. Students might also be able to work with a nutritionist or a diabetes educator to plan an appropriate diet or embark on other lifestyle changes.
Students should also take the time to identify off-campus options, including a local medical provider, since diabetes requires regular doctor visits and help from the occasional specialist.
Rights & Accommodations for Students with Diabetes
Those who have diabetes can face unique challenges in college. Fortunately, there are many ways to get accommodations on campus. The first step in the process is for students to understand what their rights are, and then to know how to ask for the accommodations they need.
What rights do students with diabetes have on campus?
Students with diabetes have the right to certain accommodations that allow them to manage their condition without detriment to their education. This is thanks to two federal laws:
These laws prohibit colleges from discriminating against a student or applicant on the basis of a disability. They also require colleges to provide reasonable modification or accommodations for those students.
What accommodations are available on campus to students with diabetes?
Students with diabetes must receive accommodations that allow them to manage their condition without interrupting their education. For most students, the requests will be relatively simple and straightforward, such as:
Taking a break during a long lecture to test blood sugar levels
Being allowed to have a box of juice or a small snack in class to treat low blood sugar
Permission to keep a personal refrigerator in the dorm room for insulin storage
The ability to reschedule an exam if experiencing low or high blood sugar levels
The option to schedule classes in such a way that a regular meal schedule is maintained
Being allowed to make up work after an absence for a diabetes-related issue
Being allowed to use an insulin pump, even in a classroom setting where “no technology” is allowed (such as during a test)
Taking a break during a class in order to inject with insulin or take other medications as needed
How can students request accommodations on campus?
For extremely simple accommodations, such as having juice during class, a request is often unnecessary. If it is, it might be as easy as mentioning to the professor the reason — most will be more than happy to grant such a simple request.
For more complex accommodations, or in cases where there is a problem, most colleges have an office of disability services that provides information and assistance. Students might need to register with the office in order to receive accommodations. At that point, the office will work on the student’s behalf to ensure accommodations and modifications are made.
Keep in mind that accommodations for diabetes (or any other qualifying condition) begin only after a student asks for them, or in some cases, only when a student registers with the office of disability services. That means that if a student does poorly on a test because they were having trouble with low blood sugar, but never informed anyone of the problem, they cannot receive retroactive accommodations; i.e., they’re not entitled to retake the test to receive a better score. Their accommodation request applies only to issues moving forward.
Do you have to tell a potential employer that you have diabetes?
Diabetes, like any other medical condition, is a private issue. The diagnosis is privileged medical information, and it’s not required to disclose it to anyone, including potential employers. However, it’s important to know that the ADA and Section 504 both protect employees from discrimination, just as they protect students. Know that if you do choose to tell your employer about your diabetes diagnosis, you can’t be discriminated against because of it.
What laws protect students with diabetes at work or at an internship?
In addition to the ADA and the 504, students might also be covered under the Family and Medical Leave Act (FMLA). This provides the opportunity for a student to take up to 12 weeks of unpaid medical leave from a job without penalty.
This time can be taken in any way that is reasonable to accommodate a medical issue. A student can take time off to attend medical appointments, for example, or a few days to deal with a medical condition that was brought on or exacerbated by diabetes complications.
However, it’s important to note that FMLA only applies to those who have worked for a particular employer for at least 12 months, have worked a certain number of hours and are employed by an employer who has 50 employees or more.
What accommodations can students request at work?
Just as with classroom accommodations, most workplace requests are simple adjustments that can be met without difficulty. A few examples include:
Being allowed to keep your diabetes supplies in the work refrigerator
Keeping food or juice in your desk to treat blood sugar lows
Permission to test blood sugar when necessary
Taking an extended break to allow blood sugar levels to return to the proper range
Other accommodations might address complications of diabetes, such as being allowed to sit in a chair if suffering from diabetic neuropathy (pain or numbness in the feet), or being able to use a larger computer monitor screen to compensate for diabetic retinopathy (impaired vision).
What should students do if they’ve been discriminated against at school or at work?
Someone who has been discriminated against because of their diabetes will need a legal advocate. This can be a private attorney or a legal advocate provided by the American Diabetes Association. To learn more about their rights and what to do if discrimination has occurred, students can call the Association at 1-800-DIABETES with any questions.
Campus Life for Students with Diabetes
Most students arrive on campus with a lot of excitement and a few concerns. For those with diabetes, the concerns might be a bit more complicated. Knowing what to expect—and planning for contingencies before the big move onto campus—can put some worries to rest.
A big misconception about diabetes is that those who have it have no chance of living a normal life. That’s patently untrue, according to Deborah Malkoff, a registered dietitian and certified diabetes educator.
“They absolutely can, just more goes into meal planning,” she says. They must also be aware of the symptoms of both high and low blood sugar, and what to do in either situation. These strictures are no different for college students, but because students are more likely to have unpredictable schedules or stumbling blocks in following a healthy diet, they’ve got to be even more vigilant.
Diabetes dorm room checklist
For most students, the dorm room is the hub. It’s where they sleep, study and socialize. Given that they spend the majority of their time here, the following items should always be on hand:
Quick snacks Have a ready stash of shelf-stable snacks, such as juice boxes, granola bars, crackers or dried fruit. About 15 grams of carbs are usually enough to raise low blood sugar; read the labels to make sure all snacks have at least that much. This is not the time to go with anything labeled “sugar free”!
Glucose tablets or gel These handy, fast-acting sources of sugar are formulated to quickly treat blood sugar lows. They can provide a small boost when blood sugar is a little low, but not too low to need a snack.
Glucose meter and supplies Along with a glucose test meter, make sure you’ve got a lancing device, as well of plenty of test strips, lancets and alcohol pads. Keep your blood sugar log (and a pen) next to it, as well as spare batteries and a small “sharps” container to hold used lancets. It’s also a good idea to have a second glucose meter as a backup, in case the first one isn’t working.
Ample medication and related supplies Make sure you have enough vials of insulin, insulin pens, oral medications and anything else you use. Keep a little extra on hand, just in case. You’ll also need to be sure you have plenty of alcohol pads, insulin syringes or needle tips, a partitioned medication container for oral meds, pump supplies and a larger sharps container.
Ketone strips When blood sugar stays high for a long time, the body starts using fat for energy. This can lead to the development of ketones, which can be dangerous. You can spot ketones through a simple urine strip test, so have them on hand for times when blood sugar climbs and stays at a stubborn high.
Glucagon On the other hand, blood sugars can sometimes plummet, especially if you incorrectly calculate your insulin dose. Glucagon is an emergency rescue medication designed to help when blood sugar drops to dangerously low levels. Make sure you—and your roommates—know how to use the glucagon kit in case of an emergency.
Important phone numbers The list should include your parents, physicians and others you interact with on a regular basis concerning diabetes. You should also have emergency numbers handy, just in case. Make sure your roommate also has access to these numbers, in case of an emergency.
Eating on campus: Do’s and don’ts
Students recently diagnosed with diabetes may fear their life will be severely limited, especially when it comes to food. However, it’s a myth that carbs and sugary foods are totally off-limits. Says Malkoff, “They just need to cover their carb intake with the correct amount of insulin beforehand.”
Here are a few other tips for eating healthy on campus and keeping blood sugars in check:
Check the dining hall for diabetes-friendly food options, like lean proteins, vegetables and fresh fruit.
Have quick snacks on hand at all times.
Count carbs in order to take the proper amount of insulin.
Learn how alcohol affects you and be careful if you drink.
Know when your insulin “spikes” so you know how long before mealtimes to take medicine.
Stick to a meal routine as much as possible.
Wear a medical alert bracelet or necklace to alert first responders to your condition.
Keep Glucagon in your dorm room and teach your roommate how to use it.
Neglect to test your blood sugar at regular intervals. This is your first defense.
Make a guess at how much insulin you need; count your carbs and figure out the correct number.
Load up on heavy carbs, like pasta or sugary desserts.
Ignore the signs of low blood sugar and hope they will go away – they won’t!
Hide your diabetes from those closest to you, such as your roommates. They need to know what’s going on if an emergency occurs.
What to Know about Diabetes & Alcohol
Alcohol is readily available on most college campuses, but drinking can lead to serious problems for someone with diabetes. “Alcohol lowers your blood sugar hours later, so overnight you are at a greater risk of going low and having a hypoglycemic event,” Malkoff explains. To avoid problems, she advises, “Make sure to eat a carb-rich meal while you are drinking, and always test your blood glucose before bed.”
The symptoms of a serious low can make someone look and act as though they are drunk, so it’s important to have a support system of individuals who are aware of the similarities and will make the effort to have you to test blood sugar rather than simply send you to “sleep it off.”
Tips for participating in college sports & staying active
Staying active is an important part of staying healthy, but those with diabetes may need to take a few precautions before hitting the gym. Here are some tips:
Track your blood sugar
Exercise may cause blood sugar fluctuations, so it’s important to stay on top of the numbers. Test blood sugar 30 minutes before exercise, occasionally during the workout and again when you’ve finished. If your numbers are too low, eat a light snack; if they’re too high, check for ketones (if you have ketones, postpone your workout for awhile).
Ask your teammates to look out for you
Shakiness or feeling flushed with heat are symptoms of low blood sugar—but they’re easily written off as signs of a hard workout. Make sure your teammates and exercise buddies recognize the signs of dropping glucose levels in case you don’t.
Figure out how your body reacts to exercise
Even if your blood sugar levels stay steady during a workout, they may drop significantly several hours later. Understand how exercise affects your numbers, and plan your activity and meals accordingly.
Choose “stealth” exercise
Fit in small doses of exercise throughout the day. Park on the far end of the parking lot, climb the stairs instead of riding the elevator and take the long route from your dorm to class. Those extra steps add up!
Consider a continuous glucose monitor
Those who exercise hard, and for long hours, might benefit from a continuous glucose monitor. Worn on the body, it provides continuous blood sugar readings, and sends an alert if levels drop too low.
Diabetes student groups
Talking with others who have diabetes is a great way to better understand the condition, pick up tips for staying healthy or simply have a safe place to vent about the challenges diabetes can bring. These campus groups can help:
The College Diabetes Network Students can find local support through campus chapters of this group, dedicated to helping college students with diabetes stay healthy.
Diabetes Support Group This entirely online group can be a resource for students who take most or all of their courses online.
Students with Diabetes Find an on-campus chapter at many large colleges and universities across the nation. Don’t see a chapter? Start one of your own!
Students can also look to numerous online support groups for individuals with diabetes (whether or not they’re students), as well as in-person groups in their local communities run by health centers, hospitals and insurance companies.
How Does Diabetes Affect Sexual Activity?
Many college students are experimenting with their sexuality or getting into serious relationships. Malkoff points out that sex can easily lower your blood sugar to dangerous levels, so it’s important to plan ahead.
“If you are going out for the night, make sure you have enough supplies in case you sleep out,” she says. “For example, bring Lantus and Novolog pens, make sure you have a fresh reservoir for your pump and bring some sort of sugar for unexpected lows.” Guys should know that blood sugars may affect sexual performance. “If your blood glucose is too low or high, you may not get an erection,” Malkoff warns.
Scholarships for Students with Diabetes
Diabetes brings challenges, but those don’t have to be limitations. There are a variety of scholarships specifically targeted to students with diabetes, offering financial assistance as they pursue their education.
Diabetes Self-Management The online home of the popular magazine, this site provides in-depth articles on things that matter to those with diabetes, from great recipes to advances in diabetes technology.
JDRF Formerly known as the Juvenile Diabetes Research Foundation, this site for those with Type 1 diabetes provides resources, support, volunteer opportunities and pertinent news.
Joslin Diabetes Center A hub of diabetes research in the United States, Joslin provides information on how to handle diabetes, as well as what to expect from upcoming innovations and research.
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