Highs and Lows: College Life as a Type 1 Diabetic

This is a paper I wrote for my writing class. It’s pretty long, but I would really appreciate your input if you choose to read through it all. Names and places have been changed for privacy.

Highs and Lows: College Life as a Type 1 Diabetic

“I’m so high right now,” I whispered to my roommate as we slid into a booth to eat lunch in Lawrence Dining Hall. I must have whispered too loudly because the girls at the next table turned around and gave me a disdainful stare for my apparent use of drugs. My face turned red and I gazed embarrassingly in the other direction. It wasn’t my use of drugs that had caused me to be “high,” it was actually my lack of drugs. I forgot to take insulin for that granola bar I ate between anatomy and organic chemistry class which caused my blood sugar to skyrocket. In fact I’m not some dope-smoking college kid; I’m a type 1 diabetic college student.

College life has become its own distinct subculture in American society. It is the time that young adults are allowed to try their limits and test their boundaries. It is an experience defined by freedom and opportunity. It is a distinct lifestyle that is often times saturated with drinking alcohol, having sex, doing drugs, eating poorly, and engaging in other risky behavior. College students have become a generic population in the eyes of American society. It seems that for a few years, young adults lose their individualism and assimilate into this community. Is this the extent of the average college student?

Type 1 diabetic students are a complicated subgroup in the college community that does not completely fit the stereotype. These students struggle with trying to maintain a healthy lifestyle while trying to fit the mold of a typical college student. They must choose between living a radically different lifestyle than their peers and facing the detrimental consequences of living the true college lifestyle. According to Myles Balfe, a medical sociologist in the Royal College of Surgeons in Ireland, “Clinicians and academics working with students with diabetes often see a lack of fit between the university environment and diabetes, noting that university environment and diabetes can almost be viewed as being two distinct lifestyle, one focused on being normal, the other on being healthy” (Body Projects129). It is a frustrating experience to have to be constantly choosing between what is good for you and what is socially acceptable, but it is this experience that distinguishes type 1 diabetic students from the stereotypical college student.

“Research has shown that students with diabetes are often concerned about not letting their diabetes affect their student lives…and might prioritize their need to be seen as normal students over their need to take care of their diabetes” (Balfe, “Body Projects” 129). For the student with type 1 diabetes, there are multiple aspects of “normal” college life that conflict with self-care regimens. These include lack of routine, absence of social support, dealing with stress, managing food choices, and managing alcohol consumption. These characteristics of college culture can be very challenging to someone who for the first time is taking responsibility of themselves and their condition.

The transformation of lifestyle that occurs from high school to college is incomparable. The most obvious change is the routine. “This will be the first time that many young adults with diabetes will be away from home and attempting to regulate their diabetes without the structuring support of school or family” (Balfe, “Body Projects”129). Leaving the structure of home life behind, students face an environment that is “more than a little structureless and chaotic” (Balfe, “Body Projects” 129).

In past experiences in dealing with my condition, I have always had a routine that supported my self-care regimen. I was diagnosed with type 1 diabetes during my freshman year of high school. The day I was diagnosed I gained an entirely new perspective on my life. I was no longer some invincible teenager that would never face the consequences of my choices. Each decision I made had a direct and tangible impact on my immediate life. Admittedly, I was a perfectionist and overachiever in high school and handling my diabetes become one more thing for me to perfect. I strived to be the ideal diabetic and surprisingly it came easy for me. The strict schedule of high school allowed me to check my blood sugars regularly, eat meals at the same time every day, and exercise consistently. I became accustomed to a daily routine that allowed me to succeed with control of my diabetes.

Having a set routine is probably the most essential part of controlling diabetes. David Johnson, a twenty-two year old graduate of Green Valley University who was diagnosed with diabetes just before the beginning of his freshman year of college experienced this first hand. When I asked him how the erratic schedule of classes and other activities affected his control, he responded without delay, “I found I did a lot better controlling when I had as strict a schedule as possible. When I was waking up at the same time every day, eating meals regularly, and maintaining a regular exercise routine it definitely helped control.” Unfortunately, with a schedule that has little organization or repetition, it is difficult for a college student with diabetes to find a routine that will allow for control.

Although the absence of routine negatively impacts a student’s control over diabetes, it serves a purpose in helping to establish normality. “The same (lack of) routine which made it difficult to engage in moral disciplinary practices were also the same routines that enabled them to construct identities as normal students” (Balfe, “Diets and Discipline” 144). For me, the need for normality overwhelmed my desire to lead a healthy life. In order to keep up with my college peers, I neglected to check my blood sugars often, eat meals consistently, or exercise regularly. My sleep patterns throughout the week were unpredictable; ranging from as little as three hours to as much as ten hours of sleep from day to day. While with my friends, the pressure to appear “normal” was overpowering. In high school, I was not concerned with this need for normalcy because my friends had the same structured schedule as myself. In school, I found most college students live their lives unscheduled and unpredictably, and I did not want taking care of my condition to interfere with how I was perceived.

By the beginning of my sophomore year in college, I felt defeated. The absence of a routine was taking a physical and emotional toll on me. I wanted to turn to my family and friends for encouragement, but when I left high school I left behind the vital support group I had become so accustomed to. So, I decided to finally put my reluctance aside and turn to my last resort: the Office of Services for Students with Disabilities. I looked their website up online and was encouraged by their mission statement: The Office of Services for Students with Disabilities is designed to assist students in making a successful transition to college life. Maybe there were some untapped resources there that I was not taking advantage of: a support group for students with chronic diseases, a counselor who specializes in working with students with diabetes. I was not sure what I was looking for, but I knew I needed help.

On a Monday afternoon, I sat in the waiting room of the office waiting for the secretary, hoping every person who passed by would think I was just there to get tutoring from the Learning Center. It is a humiliating experience to admit that you have a disability. I felt weak and pathetic, but in order to get some relief from my current situation I had to swallow my pride. When the secretary returned, I introduced myself and told her that I would like to speak to someone about how college students with diabetes can get help adjusting to college life. She directed me to Dr. Barry Smith, director of the Office of Services for Students with Disabilities, who was located in an office down the hall. I began the walk of shame to his office in the back corner aware of every glance that came my way. I knocked lightly and stepped in. He looked friendly enough, but he did not offer me a seat, and I was left standing awkwardly in the middle of the room. When I told him about my situation, he was more than willing to answer my questions. I asked him if there were any services offered specifically for students with type 1 diabetes. He told me, “There are no specific services, but if a student were to fill out the paperwork and ask for special accommodations, they will be provided for them.” “So there are no counseling services or groups that a student could go to?” I asked. I tried to stay composed and professional, but I could feel that my face was flushed and I was speaking quickly. “This office assists with mainly academic help. We don’t offer any counseling services,” he told me. Finally, I asked him if he knew of any other resources that offered counseling services. “None that I know of,” he answered flatly. Disappointed, I shook his hand and thanked him for his time. I had never thought I would end up in this situation: tired of the independent college life and searching desperately for support.

The liberating independence from parents and community may be the most defining characteristic of college life. Most college students accept this freedom as an opportunity to explore new experiences. However, for a student with diabetes this newfound freedom is also a separation from their vital support system. “The move away from parental home to become a student at a university or college in another town or city may pose problems” (Strachan 70). The absence of support can be devastating. “The loss of parental supervision and support, the initial social isolation until friends are made…has the potential to affect glycemic control adversely in the student with diabetes” (Strachan 70). This new unrestricted freedom in the college environment is a true test of a diabetic student’s sense of responsibility for their disease. Unfortunately, many college students fail this test. Fewer than one in twenty young adults with diabetes achieve target HBA1C levels (Saunders) and up to 37% of young adults already have serious complications of diabetes (Svensson). The loss of an adequate support system is a major contributor to the failure of students to effectively manage their disease.

In high school, my family and community became a safety net for me to turn to whenever I encountered problems. My family bought healthy foods, helped me to count carbohydrates, reminded me to check my blood sugar, and took on responsibility of learning as much as they could about type 1 diabetes. My high school community provided support in a way by allowing me to take care of myself without questioning me. My classmates, teachers, and coaches were very understanding and accepting. Moving on campus forced my vital support system of family and friends to dissipate. When I encountered problems and searched for a new support group in the college community, I found myself empty-handed with nowhere else to turn. Every barrier I faced, I faced completely on my own for the first time in my life. It was an intimidating feeling because I was forced to face a multitude of new challenges in a short amount of time. I tried to the best of my ability to cope with the lack of schedule, poor eating and sleeping habits, stress, and probably the most infamous aspect of college life: drinking. But in many of these aspects, I failed.

It was Friday night of Halloween weekend during my sophomore year. After a late night of partying, I headed back to a friend’s house. I was not feeling well the entire night. I had a headache and was tired. As we sat in the living room, I began to feel clammy and pale. A wave of nausea came over me suddenly and I ran outside and vomited off the side of the porch. As people walked by on the sidewalk, no one stopped. After all, it was Halloween which is one of the most notorious nights for college partying. Seeing people throw up off the side of a porch was not an unexpected or shocking sight to anyone who passed by. In their eyes I was just another college student who had exceeded my limit of alcohol that night.

Actually, I had not been drinking that night. The party I was at did not even have any alcohol. So why was I vomiting off the side of someone’s porch? My insulin pump had malfunctioned in the beginning of the evening. I had not noticed because I was too caught up in dancing, taking pictures, and talking with my friends. I never stopped to check my blood sugar once during the night. The malfunction caused my insulin pump to stop delivering insulin which caused my blood sugar to rise to above 500 mg/dl (a normal blood sugar is around 100 mg/dl) by the end of the night, which can cause fatigue, headache, and vomiting. But nobody knew this, and they just assumed I was a typical student participating in the college culture.

Engaging in the consumption of alcohol is a standard in the college environment. Because “everybody is doing it,” drinking provides a way for young people to develop a normal identity. “Alcohol consumption given its central importance in student life, provides one of the most important means for them to do this” (Balfe, “Alcohol” 247). However, this activity can be risky for students with diabetes. The alcohol in alcohol beverages lowers blood sugar. This process can be dangerous by itself, but added to the fact that alcohol inhibits good judgment makes this combination deadly. Several risk factors make alcohol-induced hypoglycemia problematic: it can be erratic in intensity and length, the inhibitor effect of alcohol makes it difficult for diabetics to recognize and treat hypoglycemia, and the similarity between hypoglycemia and drunkenness makes it difficult for people to distinguish between the two (Balfe, “Alcohol” 249). Yet young adults with diabetes often engage in these activities because “students often perceive the idea of not drinking as being risky for their identities” (Balfe, “Alcohol” 247). Once again students are motivated by a need for normalcy and conformity.

Unlike other characteristics of college life, I knew that consumption of alcohol was something that I could have definite control over. For this reason, I decided to avoid drinking completely. In this way, I felt I had some sort of management over my otherwise unmanaged condition. Many other students do choose to drink. I asked David if he engaged in drinking while he attended college. He responded, “I did drink, but I was very, very careful when I did. I told my friends about my diabetes and there was always someone to watch me. If I was going to have more than two drinks, I would definitely be eating.” Some students take the extra precautions necessary to engage in a risky activity in order to demonstrate to their peers that diabetes does not make them any different.

David told me, “I didn’t want diabetes to have too much of an impact on my life. I didn’t want it to hold me back.” He kept diabetes from isolating him from his friends by practicing strict control that would allow him to moderately engage in the same activities as his friends. However, many students with diabetes take an alternate path. Many students neglect their diabetes care and management in order to keep up with the reckless lifestyles of their peers. I saw this in myself. I felt like it was necessary for me to conform to the college norms: the lack of schedule, eating poorly, sleeping erratically, and taking advantage of the independence from family and friends. I did not understand that I really needed a set routine and a support group for successful diabetes management. I chose to avoid drinking because I knew that was one aspect of my diabetes I could have control over. But choosing to do this produced unwelcome consequences by endangering my identity as being someone who is unlike everyone else.

Society expects college students to behave in a certain way. Let’s face it, most people picture the stereotypical college kid as staying up until 3:00 A.M., eating pizza, and drinking beer. And honestly, I’ve learned that this image is not far from the truth. So where do type 1 diabetic students fit into this stereotype? Unfortunately, the ideal lifestyle for someone with diabetes directly opposes the college culture. This opposition most often leaves us caught in between maintaining some semblance of normality and maintaining some control over our condition. It is a dangerous and complicated balancing act that many college students deal with every day.

I asked David what is the best advice you could give to a student with type 1 diabetes. He paused for a few moments to think and finally responded, “Don’t let it change who you are.” But what is it that really changes who we are? Is it our lifelong chronic condition? Or is it the college culture that we cannot escape? I cannot speak for every student with diabetes, but I can honestly say that I may never know the answer to that question.










Works Cited
Balfe, Myles. “Alcohol, diabetes and the student body.” Health, Risk & Society 9(3) (2007): 241-257. Academic Search Complete. EBSCOhost. 15 October 2009. <http://web.ebscohost.com/>
Balfe, Myles. “The Body Projects of University Students With Type 1 Diabetes.” Qualitative Health Research 19(1) (2009): 128-139. Academic Search Complete. EBSCOhost. 27 October 2009. <http://web.ebscohost.com/>
Balfe, Myles. “Diets and discipline: the narritives of practive of university students with type 1 diabetes.” Sociology of Health and Illness 29(1) (2007): 136-153. Academic Search Complete. EBSCOhost. 15 October 2009. <http://web.ebscohost.com/>
Saunders, S., Wallymahmed, M., & MacFarlane, L. “Glycaemic control in a type 1 diabetes clinic for younger adults.” Quarterly Journal of Medicine, 97(9) (2004): 575-580.
Srachan, M. W. J.. “The care of students with insulin-treated diabetes mellitus living in university accommodation: scope for improvement?” Diabetic Medicine 17 (2000): 70-73. Academic Search Complete. EBSCOhost. 15 October 2009. <http://web.ebscohost.com/>
Svensson, M., Eriksson, M., & Dahlquist, G. “Early glycaemic control, age at onset, and development of microvascular complications in childhood-onset type 1 diabetes: A population-based study in northern Sweden.” Diabetes Care 27(4) (2004): 955-962.