I am a senior in high school and have had type 1 diabetes for 12 years. I have always wanted to go away to college and live on campus. However, now that the time has come for me to start making decisions about college, I am so afraid that when I go away from home, my diabetes control will vanish. Right now, my A1c is 8.0, which isn’t the best it can be, but this is while I’m living at home with my mom who is there to, at the least, keep tabs on my control. Why is it that all of a sudden I’m scared to death to leave home for college? What should I do about finding a new endocrinologist while I am at college? Should I just stay home and go to a local college? I am so scared of what the future holds as far as my diabetes and I feel as though if my diabetes get out of control the rest of my life will too!

It is very common for high school seniors to get nervous about living away at home, even if they have no medical problems. If you have been able to control your diabetes well enough to avoid hospitalizations, most likely you will be able to manage if you live at school. If you really want to live at school, you should be able to find a way to manage your diabetes at school. I think it is very mature that you realize this will be a challenge. There is also nothing wrong with staying at home and going to school nearby if you aren’t ready for this challenge yet. Perhaps you could set up a system where your mom could still help support you. Perhaps you could email your mom your blood sugars periodically so she could both help encourage you to take care of yourself and help you make adjustments. Perhaps your present doctor would be willing to review your blood sugars by email or fax to help you make adjustments when you go to school. A supportive roommate can also be very helpful. Avoiding the heavy drinking and smoking crowd also helps

Many college students prefer to keep their home doctor as their primary diabetes doctor and go to the student health service if they have any medical problems at school. Most school health service doctors are very willing to communicate with the student’s home doctor about any problems or advice to help the students. Most schools also have social workers, psychologists, or psychiatrists who are available to help students cope with the stress of living away from home for the first time and the pressure of college. You might be able to set up a plan to meet with someone periodically to get support and PREVENT problems rather than wait for them to occur. You could probably arrange to visit schools now, before you apply and ask to meet with the health service team and see what support they can provide. They may even have an endocrinologist locally they work with that you could meet. If there is an endocrinologist near the school, you may prefer to use the local endocrinologist as your primary diabetes doctor while at school.

I would definitely suggest visiting some schools before you decide that you definitely do not want to live at school. You can talk to the dean, the health service department, find out the food options, dorm options (including a refrigerator in your room), and what medical services are available in the area. You can ask if there are any other students at the school with diabetes who might be willing to talk to you. (The school can’t give you the names of other students with diabetes unless they volunteer to have their names given out.) If you have always wanted to live at school, at least apply. You can always change your mind in the spring when you see where you have been accepted. It sounds like you have the maturity to cope with the challenge. There is nothing wrong, however, with staying at home if that seems to be the best for you. What will count in the long run is how well you do in school, not whether you live at home or at school.

I wish you the best of luck in your college applications and in the future at college – wherever you go.

TGL
Additional comments from Dr. Stuart Brink:

It’s pretty normal to be scared about going away to college. And, it is also normal to feel some concerns about your diabetes self-care when away from home. But, you should know that thousands of others just like you go to school, live in the dorms and do well. So, the best thing you can do is to (first) acknowledge these concerns and (second) call and set up a consultation visit specifically with either your diabetologist or nurse educator and see what they think. They can probably give you names of their colleagues at different schools who are nearby and can work with you and your diabetes. We do this all the time for our patients. Some decide to stay at home and some decide to go away to college. We can also stay in touch with you via e-mail, so, your own diabetes team may also have this option available for you. If necessary, you may also want to see a counselor, social worker or psychologist, depending upon who works with your diabetes team, and discuss some of these worries professionally so that you have a better handle on how to proceed. Diabetes Forecast had a great article about college life and diabetes a few years ago, which may be available through the ADA web site, if your team doesn’t already know about it.

SB
Additional comments from Dr. Andrea Scaramuzza:

I think that your reaction is quite normal; diabetes could be very discomforting. Going far from home without your parents near you could be frightening. I think you can try to go to college and see what will happen; it would be wise to find an endocrinologist near your college so you can ask advice if you need it. Otherwise, the risk is that it is the diabetes will lead your life while it is you that have to lead it (after taking care of your diabetes as better as you can)

I would like to share with you what I think about diabetes and what my patients and I think about “your” relationship with it.

The Insulin, Love and Care Project: The new way to view diabetes and, above all, build trust between doctor and patient.

There is no such thing as bad diabetes, just one that is difficult to manage. Diabetes is not only an enemy to overcome, but can also be a partner who is demanding with whom you have to and can learn to live.

Being happy is more important than living a “normal life.” It helps to face diabetes with a smile. And while not neglecting it, a patient can do most of what his friends can do.

Good self-care is a must. Gradually, with age, a child should learn to manage his/her diabetes in order to become more responsible and independent.

Hiding one’s diabetes doesn’t do anyone any good. Diabetes is not a disease that should be hidden. Talking to others about diabetes helps to accept this condition, and become more relaxed.

Knowing that poor control is our common fault makes cheating unnecessary. It is not only your fault if the treatment result is poor! The team/your collaborators and you have a common responsibility. We rely upon you! Cheating is to give up!

Having relaxed parents by your side is important. Your parents must be supportive without being invasive or overly protective.

Teachers and educators have an important role. The people who spend time with the child or adolescent on a regular basis must not keep him from being himself. That attitude often makes the child feel “different.”

The doctor is not just a mechanic for the body. The doctor should not limit himself to dealing with the disease, but also caring for the person burdened with questions and fears, anguish and hopes.

Doing it together is easier than by yourself. Facing the condition together with others is certainly easier. It helps you feel less alone, encourages a dialogue with those who share your problem, and helps you follow the rules imposed by diabetes.

To live with diabetes does not mean a “normal life,” but a long, exciting, happy life! Diabetes is something to live with. Do not fight, but learn to live together as friends.

AS
Additional comments from Dr. Larry Deeb:

I live in a college town and see lots of kids who come here to go to school. Most do just fine…take care of the diabetes. It is very possible.

May I suggest you think about a very flexible treatment regime? Maybe a pump or a mixture of Lantus and mealtime insulin? It provides you with the ability to be flexible with meals.

You will need to be responsible, but I see many successful college students here.

LD