10 Tips for Surviving College with Type One Diabetes

College—a time filled with pulling all-nighters in the library, sleeping through your 8 a.m. alarm, binge-drinking and budgeting—takes a toll on anybody’s physical and mental health. Add on an auto-immune disease like Type One Diabetes, and an already stressful time gets ten times more stressful. Never fear: Just because your pancreas no longer makes insulin, it doesn’t mean you can’t enjoy the best four years of your life.

Check out these 10 tips for surviving college with Type One Diabetes.

1. Befriend Another Diabetic on Campus

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You’ve been fighting high blood sugars and counting carbs for a long time. No matter how long you’ve had the “’betes,” you can’t fully avoid mistakes or mishaps. Knowing another diabetic on campus can relieve some of the stress emergencies bring. Not to mention, forming a ‘betes squad can calm the nerves of your concerned mother by letting her know you’re not fighting the ‘betes alone. “In case of an emergency, you can get a glucagon or test strips. There are times when my meter breaks and my friend Kailey has an extra and I’m like, ‘bless your soul,’” said Creighton University senior Betty Straub. Constantly maintaining your blood sugar levels without going insane remains a difficult task, but a shoulder to lean on will carry some of that burden.

2. Be Honest About Your Diabetes

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Diabetes can seem tiresome, burdensome and maybe even embarrassing at times. Resist the temptation to hide your diabetes from the world. Handling your diagnosis in secrecy will only create more problems in the long run. Show your roommate how to operate your machinery. Warn your friends at the bar to watch for signs of low blood sugar. Tell your professors beforehand that you may need a snack during class. If those around you can help you in any situation related to your diabetes, it will only remove stress from your life. Your blood sugars will thank you.

3. Prepare for the Dining Hall

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Once you get to your college’s dining hall and realize you can fill up as many plates as you want, all those freshman fifteen horror stories don’t seem so farfetched anymore. But do try to avoid the Freshman “Worst A1C I’ve Ever Had.” With unlimited breakfast, lunch, dinner and dessert options at your fingertips, you may find yourself overloading with carbs. “It’s so easy to put a little of this on your plate, but then that turns into two hundred grams of carbs that you weren’t exactly counting. Stick to things you know how to count and don’t graze at meal times,” said University of Iowa sophomore Maddie Walding. Check if your dining hall displays nutrition facts and don’t be afraid to bring measuring cups to obtain the most accurate carb counts. Keeping all of your toes beats the ignorant nonsense people will say about kitchen ware in your backpack any day.

4. Pack Your Backpack with Emergency and Backup Supplies

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We’ve all felt that panic when your Dexcom starts dropping fast and you can’t find a gram of sugar to save your life—literally. Keep your backpack stocked with every possible item your diabetes could demand of you. “It’s better to have it and not need it, than to need it and not have it,” said Iowa State University alum Jace Wallerich. Stock up on sugar, a glucagon, back up pump sites, test strips—just make sure your backpack puts a med student’s to shame.

5. Educate your Roommate and Friends

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Make sure those you spend the most time with know how to take care of you. The extra effort could save your life one day. You’ll probably spend as much time with your college friends as you do with your diabetes. They should know how to keep you alive when the ‘betes takes a turn for the worst. Teach them to recognize the signs of a low blood sugar, how to operate your insulin pump and how alcohol affects your blood sugars. “Don’t assume that because they are a nursing student they’ll know how to do it,” said University of Iowa senior Kayla Klein. By the end of freshman year, make sure your best friend can tell the difference between your “studying for eight hours straight” goofy mood and “my blood sugar is 60 and dropping” goofy mood.

6. Know your limits with alcohol and drugs

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Just because your pancreas crapped out on you doesn’t mean you aren’t a normal college student. You’ll probably want to partake in some of the staple extracurricular collegiate activities (alcohol and drugs). Before you do, you must know your limits and how they will affect your blood sugar. “For me, alcohol spikes my blood sugars and then I level out. If I take any insulin beyond my basal, I will go low by morning. A good intentioned friend may see your reading high and give you a correction,” said Iowa State University alum David Blacksmith. Refer back to tip #5 for a moment. Make sure your friends know what to do in case the worst happens while out at the bars. Because of how hard your liver works to rid your body of alcohol, you must remember that your glucagon won’t work while drinking. Eat a snack when you get home from a wild night at the bars to both soak up the alcohol and avoid waking up to your CGM harassing you at 7 a.m. Talk about a rude awakening.

7. Contact Your School’s Disability Services

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When your site falls out in the middle of the night and you wake up vomiting with a pounding headache, your blood sugar in the four hundreds and large ketones, the last thing you want to do is take your chemistry midterm. Make a plan with your school’s disability services to protect yourself in case of an emergency. “My school offered the Center for Academic Excellence which helped me deal with professors so I could have testing supplies and sugar during tests. I could also get a retake if I went low during a timed test,” said University of Iowa first-year medical student Tyler Larson. You wouldn’t take a test drunk (hopefully), so don’t try to take a test with a low blood sugar. Your school can also work with you when taking tests for licensure or to get into grad school, like the MCAT, so you can be allowed to take sugar and any device with you into tests. These departments want you to succeed. Don’t let your diabetes get in the way.

8. Monitor how stress affects your blood sugars

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Every college student experiences stress. If not, please tell me your secret. Most college students don’t have to deal with how that stress affects your blood sugars. Pay close attention and test often to know how your body reacts during an all-night cram session. “I increased my basal when I was stressed. I always did this during finals week. Also because I typically didn’t exercise as much,” said Larson. Log this somewhere safe so you have a plan of action the next time finals week rolls around. Do not fear increasing your basal rates or adding extra carbs to your snack. Remain diligent in your diabetes care, and you’ll ace your finals AND your next A1C test.

9. Wear a CGM If Possible

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Our endocrinologists scold all of us for not testing enough at least once in our diabetic lives. If you’ve escaped the dreaded, “Why did you only test once two Mondays ago?” conversation, consider yourself lucky. Wearing a continuous glucose monitor (CGM) can take out the extra step of poking your finger and allows you to constantly see your blood sugar levels in real time. This life-changing device allows for tighter control, a better A1C and a lower chance of complications later in life. I managed to score my lowest A1C of my life during my first semester of college thanks to the wonderful Dexcom. Looking for another cool option? Then try the Guardian sensor that works with the Medtronic 670G insulin pump to change your basal levels based on your blood sugars. We all know the healthcare system stinks, so a CGM does not prove to be an affordable option for everyone. If a CGM doesn’t reside in your future, stay diligent on testing your blood sugar. We want you to be the healthiest diabetic you can be.

10. Remember: You Can Do Anything Despite Your Diabetes

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Nobody will deny that Type One Diabetes is a pain in the booty from time to time, but you can still live your life whichever way you want. College is about exploring your interests, meeting new people and trying new things. A busted pancreas should never stop you from reaching your highest goals. “I wanted to take a scuba diving class in undergrad and we had to get a physical done for the class. My endo at the time told me I wasn’t allowed to take it because of my diabetes, and I settled with being told that. Now I’m gonna go climb a mountain, diabetes and all, so that doctor can go suck it,” said University of Iowa fourth year pharmacy student Jordan Langreck.