Giving the Lowdown on Lows

The prescriptions are filled, the paperwork is filed, and the batteries are charged. It’s almost college drop-off day, and all the preparation you and your rising college freshman have put into making this major life transition a smooth one is almost done — except for one last step!

And it’s an important one: helping your child build a brand-new safety net of people educated about type 1 diabetes. From new roommates and friends to dorm staff and professors, here’s how to help your child explain the (literal) highs and lows of T1D.

Who Should Know About Your Teen’s T1D?

Unlike your child’s elementary and high school years, there are no hard and fast rules in college for who needs to know about your child’s diabetes. But as a general guideline, anyone who would need to assist if your child has a severe low blood sugar is a good person to tell. This includes:

Roommates: It’s possible that your child’s new roommate has never met someone with type 1 before or has limited knowledge about it. Revealing diabetes to a college roommate is important, but it doesn’t need to feel like a premed lecture.

“Letting a new roommate know about type 1 is simply another part of the student describing who they are. They’re from a certain town, they have two older brothers, they like baseball… and they happen to have type 1 diabetes,” says Mark Heyman, Ph.D., C.D.E., director of the Center for Diabetes and Mental Health in Solana Beach, California.

As for when to initiate this conversation, Stacey Cunnington, a communications assistant with the College Diabetes Network, recommends doing it sooner rather than later. “Some students find it less stressful to tell roommates over text or email when they’re introduced during the summer so they don’t have to do the heavy lifting once they get to campus. If they’d rather tell them in person, an easy way is to casually take out a testing kit or pump when they’re eating together and slip it into conversation that way.”

In explaining lows, the goal is to educate roommates about severe hypoglycemic episodes without making it feel like the burden of monitoring and watching for lows is somehow being shifted to them.

“When the topic of diabetes comes up for the first time,” says Cunnington, “they could phrase it as ‘usually no big deal and just a part of my daily routine. But super-low blood sugar could happen. If it does, I’ll probably look drunk or really confused. In this situation I will usually be able to eat or drink some fast-acting carbs and be fine in a few minutes. But if I lose consciousness, you’ll need to help.’” Then the student can describe the steps for administering emergency treatment for severe hypoglycemia and calling for additional help.

Resident assistants (RAs): The dorm’s RA is there to facilitate a sense of community among students, answer questions, and enforce residence policies. Sharing information about diabetes with an RA provides one more person in a student’s immediate living environment who is educated about what to do if your son or daughter needs help. Don’t assume the RA already knows about your child’s diabetes! Depending on privacy policies, the RA may not have been informed about students’ health status.

Health services: To start connecting names and faces and feel more comfortable should assistance be needed during the academic year, encourage your child to stop by the school’s health services office to say hello and meet staff members. Health services can also give your child practical information, such as where designated sharps disposal containers are on campus. For the best get-to-know-you visit, time this meeting before the start-of-semester rush begins or when your child is dropping off college health forms.

Dining hall supervisor: Accessing correct carb-count information for foods is a big part of keeping blood sugar levels within range. The dining hall supervisor or other staff members can give your child needed nutritional information as well as help with any special dietary accommodations.

Local endocrinologist: College students living far from home should consider establishing care with a local endocrinologist, recommends Heyman: “If the student needs help that is specific to diabetes, it can be faster and easier to get this help from a local endocrinologist and diabetes care team.” Your child may still maintain connections with their hometown diabetes care team if preferred. Before the semester begins, investigate which endocrinologists are close to your child’s college and ask your current team for recommendations.

Friends: As much as parents may not want to think about it, college parties happen. And if your child plans to attend one, it’s best that he or she attend with a friend who is educated about how to recognize lows. “We recommend that students always have a friend who knows they have T1D, what signs to look for, and what to do in an emergency. Having a low blood sugar can look similar to being drunk to the untrained eye,” notes Cunnington. In general, it’s a good idea for your child to educate any new friends about diabetes and lows.

Disability/auxiliary service: A college’s disability/auxiliary services can usually contact professors on a student’s behalf or provide resources on how to speak to professors about necessary accommodations. If a student had a low and missed an exam as a result, disability services may be able to facilitate a new exam date or some other resolution. “Students with diabetes may not think of themselves as having a disability, so they may overlook this extremely valuable resource for help,” says Heyman.

Other students with T1D: Finding and connecting with other students with T1D is a great confidence booster, and they can provide a sounding board for all of these conversations your child is having with others. To find other T1 students, encourage your child to join or start a College Diabetes Network chapter. As Cunningham explains, “This means they’ll always have someone on campus to lend a helping hand.”

For more information about helping your child succeed at college, request free copies of the CDN’s Off to College Booklets.

 

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

 

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