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Trust me. It’s chronic. And it’s not what you think it is.
Different drugs, different highs, different lows. Because of one dead organ.
If you didn’t think what I thought you were thinking, then good for you.
It was six months after my sweet 16 in May 2010. The family practitioner rushed into the patient room that day looking alarmed and a bit woeful when she shared the news with me and my dad.
I had Type 1 diabetes. My pancreas totally gave up.
Because I had such high blood sugars, I was immediately rushed to the emergency room at Children’s Hospital Los Angeles, and within 10 minutes was connected to the IV. My blood sugar was over 600 mg/dL. Normal blood sugar levels are usually less than 100 mg/dL, 140 at most.
The following morning, I returned to the hospital to get diabetes care training, and that’s when I finally understood that the crux of managing my chronic disease revolved around strict monitoring of the amount of sugar in my blood.
I never would have thought that my childhood obsession with reading the nutritional facts on the side of my Cheerios cereal box would one day become a lifelong necessity. Go figure.
As part of the diabetic regimen, it was necessary for me to study the labels of everything I ate in order to calculate the carbohydrates and the right dose of my insulin injection to avoid high blood sugar levels.
Making the life adjustment throughout the remainder of high school was hard, to say the least. But over a period of time, the routine became automatic, almost mechanized. I had to do this to survive, supposedly.
Fast forward two years later to November 2012. It’s a typical Thursday night at a cafeteria with some friends, indulging ourselves with food and going back for fourths — pizza, fries, ice cream and Froot Loops from the unlimited cereal bar. I had consumed more sugar and carbs than I could count for.
Later that night, my blood sugar number rose to over 500.
Welcome to college.
According to the American Diabetes Association, out of the 2.3 million freshmen that enroll in college every year in the U.S., nearly 7,700 of them have Type 1 diabetes. Type 1 diabetes — also known as juvenile diabetes — occurs when the pancreas no longer functions properly and ceases to produce insulin which leads to higher blood glucose levels. Constant blood glucose monitoring, administering insulin at meal and snack times and making sure to stay within the target range are musts in order to avoid short-term and long-term complications.
Unfortunately for diabetics like myself, college isn’t exactly the best place to control such a disease. And in many ways, it makes self-management much more stressful and overwhelming. One of the most crucial aspects of managing diabetes is discipline and avoiding excess stress. College life seems to entirely contradict both. The attention to detail and effort that I need to spend on managing my blood sugars can easily wear off with the spontaneity of college.
This becomes especially challenging with managing classes and striving to get good grades. With the pressure to achieve a high GPA, much of my focus was rushing from class to class, spending long hours laboring over midterm papers, nervously sweating over exams and in-class group work.
My biggest fear is having my blood sugar drop down too low, called hypoglycemia, or get too high, called hyperglycemia, while taking a test in class. Both can lead to having bodily symptoms that may not always be apparent.
Symptoms of hypoglycemia include weakness, sweat and trembling, and for hyperglycemia, it’s usually extreme thirst, blurred vision and fatigue.
In freshman year, there were a few occasions when I experienced lows and highs that caused major distractions during test-taking. For diabetics, it’s highly recommended to check your blood sugar level and do insulin correction if needed beforehand and make sure to bring a small juice box or a few glucose tablets if you need to raise your blood sugar quickly.
Everything involving food is at the center of the universe for a diabetic — or at least, it should be.
And this is probably true for anyone else who has an allergy or disease that is affected by food. College students stereotypically eat unhealthy foods, a stereotype that has at least been proven true for me. Using Tapingo to order curly fries and cheeseburgers from the campus diner late at night or making an ice cream run to the convenience store at 10 p.m. was almost like second nature.
While indulging in these types of food occasionally isn’t completely taboo for a diabetic, it requires tremendous willpower to say no and risk being the odd one in the friend group.
(Then add that social anxiety I talked about to the mix and see what you get).
Even though it’s important to avoid these types of junk food to reduce the likelihood of having all kinds of complications in the long run (that could affect your heart, kidneys, eyes, you name it), the wide consumption of unhealthy foods in college makes it very tempting to simply take your insulin and hope for the best.
Eating becomes strategic.
I have to consider timing, carbohydrates, sugar, blood glucose levels, preceding meals, upcoming meals and other factors before eating anything. Nowadays, my insulin pump does most of that thinking for me.
Planning is key in managing diabetes or any type of chronic disease.
Do you have enough insulin? Blood test strips? Alcohol swabs? Snacks? Juice boxes? These are things that most college students don’t have to think about on a regular. This is where college life can get complicated for someone with a chronic disease. College is synonymous with irregularity (to say it nicely).
Some of it, I know, is on me because I have to accept the fact that I have a chronic illness and it has to always be on my mind. But the environment that I’m in also plays a major factor.
Although I am doing better in managing my disease today in graduate school, the adjustment period was extremely difficult freshman year. However, I found some helpful resources along the way that have made the process less psychologically daunting.
One of the biggest resources on campus was the student health center. Not only did it provide free basic medical services to all students, but it also provided preventative care for chronic diseases such as diabetes.
Another major resource more specifically geared toward diabetics (but could be useful for anyone with a chronic illness) is Beyond Type 1, an online website that provides a wealth of information and resources for folks with Type 1 diabetes. It also has its own social media app for peer support with other Type 1 diabetics (and it’s free!).
What have been most beneficial for me are Beyond Type 1’s online blogs that feature stories of other young people who are also juggling diabetes and college life as well as their surplus of information and tips on how to manage diabetes while in college.
For example, they have tips on dining hall eating — a huge concern for any college student that is dealing with a chronic disease and needs to watch what they’re eating. Some of these tips include meeting with the staff that is in charge of the dining halls at the college to seek special requests like extra fruits and veggies or to ask for access to nutritional information for food served at the buffet.
They also provide tips on how to manage relationships with friends when talking about diabetes and how to communicate about touchy topics that are often linked with a chronic disease, such as eating disorders and depression.
And, believe it or not, Instagram has also been a phenomenal resource. There are a number of people with Type 1 diabetes who share their experiences through their accounts and it’s helped me catch some inspiration whole scrolling through my feed on a Saturday morning. Just follow Beyond Type 1 @beyondtype1 and go from there.
Dealing with a chronic disease such as diabetes as an undergraduate or graduate student is daunting and can take a serious toll on your mental health. I know for me, ignoring my diabetes can make me feel lousy and frustrated, and if I ignore my feelings, it only makes managing my illness that much harder.
The most important thing is to not be afraid to seek help either from your college student health center or by reaching out for support, even if it is online. Also, talking to those who also have a chronic illness can be a relief, especially when you find out that some of them may be struggling with the same feelings.
Even though I am still a work in progress as far as managing my health, I am also learning how to not be defined by my chronic illness and become more compassionate to my freshman self.
Are you interested in the Medi-Cal Peer Support Specialist Certification Training? New Classes begin October 24. Space is limited.