8/22/2019
Taking Your Diabetes to College: Q & A with Courtney Melrose, RD, CDE
“Plan to be spontaneous”

Going off to college is a time of challenge and change for anyone, but if you are a freshman with type 1 diabetes (T1D), starting college can be the adjustment of a lifetime.

“When we transition to college, our parents aren’t around; we have new friends, new adventures; new experiences. Diabetes sometimes takes a back seat, but we always want to be safe,” said diabetes educator Courtney Melrose RD, CDE who runs a popular workshop at the Berrie Center called Taking Your Diabetes to College. Here are a selection of questions that Courtney addressed at the most recent workshop. We hope this information will help to ease the transition to college.

Q: What do I do if I get sick?

Courtney: Call your parents and the Berrie Center immediately if you are not feeling well. This includes if you are nauseous or have stomach pain; if you are vomiting, have diarrhea, high blood glucose with moderate to high/large ketones, fever over 100.4 degrees F, or shortness of breath. On sick days, make sure to keep hydrated, check your blood sugar every 2-3 hours, give corrections for elevated blood sugars, and check ketones. If you can’t keep fluids down, be prepared to go to a local hospital for treatment. Tell a friend or your parents that you are not feeling well. Don’t try to manage it alone!

In case of illness make sure you have easy-to-eat foods such as sugar free jello, chicken broth, crackers, carbohydrate-containing beverages, such as Gatorade (for low blood sugar), and diet drinks (for high blood sugar). Do not stop your insulin! Even if you are not eating, it is critical to keep taking insulin.

Q: How can I avoid the “Freshman 15”?

Courtney: The best way to avoid weight gain is to set a schedule to adhere to it. Try to eat meals instead of grazing. Become aware of non-hunger cues that motivate you to eat: sadness, loneliness, stress, anxiety, anger, boredom. Figure out what works best to distract you from choosing food and helps you to address what the actual issue is. Remember that food will not fix the feeling.

Exercise is extremely helpful in reducing anxiety, stress, and depression. Find a friend to do activities with. Exercise can be fun with other people and help encourage you to be more consistent.
Scope out the options at the dining hall! Make a trip around the dining hall before getting in line. And try to avoid fried foods!

Q: What do I need to know about drinking and T1D?

Courtney: To begin with, I always remind my patients that drinking under 21 is illegal. Drugs are illegal. NEVER drink/do drugs and drive. And NEVER get in a car with someone who has been drinking or doing drugs.
I am very honest and real with my patients. The fact of the matter is there are always going to be college age kids who are drinking, and we want them to do it responsibly. Alcohol impairs the body’s ability to guard against hypoglycemia. Blood sugar will often rise after alcohol consumption and then decrease hours later.

Tell your friends you have diabetes—being low can look very similar to being drunk. Show your friends what they need to do in case of an emergency. Eat before going out or have a snack with your drinks. Avoid boxed wine, cider, mystery punches or anything sweetened with sugary liquids. Drink plenty of water: before, during and after a night out. Make sure to know your blood sugar before you go to sleep for the night and wear a sensor. Leave glucose treatments by the bedside before you go out at night. Do not forget to inject long acting insulin if you use multiple daily injections before going out, and definitely avoid binge drinking.

Q: What do I need to know about marijuana and T1D?

Courtney: Marijuana indirectly affects blood sugars by impairing your ability to make smart decisions. We tell people not to smoke marijuana, but if they do, they need to think through it and realize that they might make poor decisions. We often see high blood sugars because people tend to eat more when they are high.

Patients need to think about the big picture. How will drugs and alcohol impact your overall college experience? How will it affect getting to class on time, completing work, getting the most out of the experience? I tell patients they don’t want a bad experience with drugs and alcohol to taint their college years.

Q: Any other tips on how to prepare for the unexpected?

Courtney: No matter where you go, always make sure you have low blood sugar treatments on hand. If you are going to a party or planning a night out with friends, consider wearing an extra pump site in case your site falls off. Another suggestion is to pre-fill a syringe with 15 or 20 units of fast acting insulin to carry in these specific situations when you will be away from your dorm and it might seem inconvenient to go back. If your pump site falls off then this allows you to have an emergency backup. If something happens, you will not be without insulin.