Parents and students should plan ahead for a healthy transition to college life.
Going away to college is a major life event for the student and the parents. For the future student, it is the first time s/he will be living away from home for an extended period of time. It's a time fraught with both excitement and anxiety; the real beginning of an independent life unfolding into the big world, where anything can and will happen. Even if you didn't have diabetes it would still be a lot and it would be normal to be a little nervous. One way of minimizing the separation anxiety is to do the right thing by preparing ahead of time for how to manage your diabetes away at school. The focus needs to be on making a smooth transition for both the college student and the parents, for if both concerns are not acknowledged and addressed, it may be difficult for everyone to move on to the next phase of life.
Whom do you tell that you have diabetes? Everyone? No one? While you were at home you probably had a diabetes team of healthcare professionals whom you knew well and who knew you. You may want to continue your care with them even though you're moving away, but you'll also need to establish some kind of relationship with student health or local providers to help address any healthcare concerns during the time that you're away from home. For instance, in the event that you break a bone or feel ill or have a medical emergency, it's important that whoever is caring for you knows about your diabetes.
The easiest way to find someone competent in a new town is to ask your current physician for a referral. After getting a few names – and prior to your moving – you should call that physician's office to make an appointment for some time after you've gone through college orientation. Ask your current doctor to send copies of your medical records to the physician you'll be using away at college. Schedule and make that first visit – even though you really don't feel like it! The most difficult part of working with a new doctor and nurse is that it's like starting all over again. Push through that desire to not do it and get it done. Your current doctor will be happy to call the person you're working with at school to help move along that getting-to-know-you process. The idea here is to establish some kind of relationship before something happens.
You'll also need to tell some of the people you're living with about your diabetes. You may feel uncomfortable about asking for help but you'll get to see just how much people do want to help you, how good it feels to be supported and experience just how nice it can be to learn how to rely on people who were at one point strangers. You'll learn what it feels like to open yourself up to others and be available to them as well. You'll realize you don't have to do it alone!
If you're living in the dorms, let your Residence Advisor know about your diabetes. Have a brief discussion with your roommate(s) as well; let them know about the signs and symptoms that you get when you're low and what kind of help you need from them when you are low. Give people the information they need to be available to you in case you need it. A discussion ahead of time is helpful for everyone. It gives you the opportunity to articulate just what works best for you and helps your new acquaintances know exactly how and when to help you – successfully striking that delicate balance between considerate help and overprotection or intrusion.
Get the most out of "teachable moments" – times when you're in the process of checking your blood sugar or giving yourself some extra insulin to cover extra food or drink, etc. It's education on the run and it's effective because it's teaching while doing. Although this may be difficult, you will probably need to teach your roommate how to give you glucagon in the event that you need it. Be sensitive and reasonable in your approach to talking to someone about this. They may be as reluctant as you to do this but it will help them not "freak out" about it.
Remember, you don't have to tell the entire campus that you have diabetes – just those with whom you'll have daily, close contact. And you don't have to train them to become diabetes experts either. Just give them some background info so that they get the general idea and understand what kind of help you need. They'll become more expert and helpful over time as they watch you successfully deal with your diabetes on a daily basis.
Your New Digs
Make sure to have a small refrigerator in your room to keep your insulin and food you like to take for lows. You may need to request special permission from the dorm facilities. Sometimes freshman aren't allowed to have extra appliances but your diabetes qualifies you for some special privileges so take advantage of them! You might want to leave a small extra supply of insulin, infusion sets/syringes, and glucagon with the residence advisor on your floor in case you can't get into your room. Glucose tabs are great – they're easy to take and don't spoil. Keep some Power Bars or similar snacks around also just in case.
At least for the first semester you should have more than you need in terms of diabetes-related supplies. After the first semester you'll have a better idea of what and how much you need. Just use your head and common sense. Over the course of time, you can modify your care plan to fit the circumstances as you become more familiar with your surroundings.
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...