Editor’s Note: When kids go off to college, it’s likely that their diabetes treatment routine will be out of parents’ hands. Elna Narula’s daughter, who was first diagnosed Type 1 at nine years old, just graduated from college. What mother and daughter learned is that successful treatment strategies at a distance don’t develop automatically, but must be constructed. This article, adapted from an original story in Diabetes Wellness News, is published with the permission of the Diabetes Wellness & Research Foundation. It will help prepare soon-to-be-freshmen D-kids and parents to meet the challenges of staying well at college, when parents are far away.
Going off to college is a rite of passage for many older teenagers. But for Type 1 teens and their parents, it is an even bigger deal. College changes the whole paradigm of caring for a diabetic child. I found this out first-hand four years ago, when my daughter left for college after I’d treated her for Type 1 since age nine. If, like me, you’ve taken charge of your child’s care for years, his or her college departure and life away from home can be scary for both of you. As a parent who has gone through the transition, I offer some helpful hints for mom, dad and college-bound child to aid in the transition:
1. Parents, find and acknowledge a care comfort level that works for you. Help your son or daughter take charge of their own care. Be proactive now, so you’ll be able to relax and feel comfortable when your Type 1 child is no longer living under your roof. If one or both of you know that your Type 1 teen needs to do a better job at independently adjusting his or her basal rate or calculating boluses or carbs in a meal, do not wait. Have that conversation now, before your child finds himself or herself adrift in a sea of wildly fluctuating glucose readings in the fall. As a nurse, I’ve seen far too many cases when a child had been in great control for years, only to lose it in college, all because well-meaning parents managed everything. Don’t make that mistake.
Kids, if your parents have been taking the lead on your diabetes management, now is the time to step up and learn how to function independently. Utilize your CDE/endo/classes, whatever it takes – but brush up on those handy life skills you must have to survive and thrive with T1.
2. Work together to decide how you will communicate with each other before school starts. It’s easier than ever to stay connected, but it still requires putting in some effort. Talk together about how to make that happen before school starts.
Kids, this is a big one for your parents. Since you were diagnosed, they’ve done everything they can to help you, and they have felt needed. Your departure is a big adjustment for them too. They need to hear from you, and know how you’re doing, regularly. Agree on a communication system that works for both of you. Even a simple text message saying “I’m alive” or “My bg is such and such” might be enough for some families to feel connected. For others, it may be a brief phone call every few days or on weekends.
3. Create a game plan for getting diabetes supplies while at college. Come up with a plan that works for both of you. It’s good practice, since diabetic kids have to learn to order supplies for themselves eventually. Some strategies include having standing three-month supply orders through the mail, or at a local pharmacy. You also can make a list of everything and have your child fill in when each item will run out, so that either of you will have sufficient time to order beforehand.
4. Yes, you want to have “that talk”. Sex, drugs and alcohol exist in the diabetic’s world, too, and it’s best to talk about it before your child moves into a dorm room. Now is a good time to find articles in diabetes magazines or on Web sites about alcohol’s effect on diabetes, and to brush up on handling hypoglycemic emergencies. Here are two links to articles I’ve found particularly useful: http://www.everydayhealth.com/type-1-diabetes/type-1-diabetes-and-alcohol.aspx and (http://en.wikipedia.org/wiki/Glucagon_rescue ) If you’re not comfortable discussing this, your friendly endocrinologist team/CDE/support group comes in handy. But, no matter how you broach the subject, it needs to be discussed.
5. Check out the health services at your child’s college. Parents, make sure that your level of comfort here is met. You can call and talk with the nurse or the director of the school’s health team. They’ve had other T1 kids at the college, and hopefully they can reassure you. You may choose to find a new endocrinologist in the vicinity to have as your child’s primary MD or as a back-up, but it’s better to identify someone now rather than later.
6. Kids, anticipate how to deal with the changes in your daily schedule. One of the remarks I hear most often from diabetic kids after their first year is that they did not realize how tough it would be to deal with schedules that can be different every day. College life is so different than home life, and late nights and weird eating and sleeping patterns can get to you. Whatever schedule you adopt, try to make it consistent. Yes, you actually do need sleep and to eat at certain times. That’s important for anyone, but especially so for diabetics.
7. Tell your new friends and acquaintances on campus about your diabetes. I had an agreement with my daughter that I would not go around knocking on doors to meet everyone on her dorm floor to demo the glucagon rescue kit if she would just promise to at least tell her roommate and other people who need to know and could be counted on to help. Also – and this is non-negotiable – kids in college need to get and wear a medical ID of some kind that tells people they have Type 1 diabetes, because emergencies don’t always occur when you’re surrounded by people you know. Wearing that bracelet 0r having that tattoo can save your life.
8. If possible, connect with other diabetics in your new college community or at least online. Try the College Diabetes Network, a wonderful resource with chapters all over the country , and growing all the time at www.collegediabetesnetwork.org. CDN was started by Christina Roth, a Type 1 who saw a need and addressed it. And if you don’t want to meet people physically, there’s a large online network. For details on all sorts of great Type 1 blogs and websites, check out http://diabetesadvocates.org/resources-for-type-1-diabetes
9. Cover your bases. Anticipate and plan ahead. Talk to other Type 1 families who have already gone through this. Make a list of the things you all need to do so everyone feels comfortable, and be as prepared as you can be. Yes, write it down. Keeping it all in your head isn’t enough.
10. Most importantly, it is still about the journey – and kids, you are about to embark on an amazing one! Make it fun and give it all you’ve got! Parents, be grateful that you have done your job to get them to this jumping off point! You have given them their roots, now let them spread their wings to fly.
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