college essay about type 1 diabetes

Life with Diabetes: A College Entrance Essay by an Amazing Young Woman

Wednesday, february 22, 2012, 15 comments:.

Stephanie, Good luck...your attitude and spirit will see you far in life. Thank you so much for allowing Hallie to share this with us. My son is 8. "D" isn't on his radar yet...too busy with hockey. I have a feeling we will struggle on and off over the years. I have encouraged him to try a "d" camp and he is not interested yet. I do think it is so very important to realize some "same-same" in all of this. Love to you and your fam, Reyna

Stephanie, Thank you for that and thank you Hallie for sharing it. My 10yo daughter is only four months into this D-life but I hope she grows up to have such a wonderful attitude! She will be going to a D-camp this summer and I hope it helps. Thank you for the encouragement! I might just let her read your essay. Julie

Stephanie I've been contemplating camp for my 9 yr old who's only been dx for 7 mths, thanks for the encouraging word we will look into it now. She has no one at her school and still doesn't like to test and take shots in front of people. Thank you for sharing your essay. Jennifer, mom to Sophia

Stephanie, Thank you for sharing your beautiful words. As a parent of a T1 child, I find your insight into this secluded world both interesting and encouraging. My nine year old daughter was diagnosed last May. I think so far she has struggled most with the feeling of being different than her peers. She has recently begun to feel the sting of exclusion from parties and play dates with the other girls in her class because of ignorance of this disease. Thank you for the reminder that diabetes can have some positive effects in her life to slightly off set the long list of negatives. I pray that some day she will have as positive an attitude as you do. Thank you for the much needed encouragement. May God bless you in all that you do.

Thank you, Stephanie, for your sweet words! You are mature for your age, and I'm so proud of you. My daughter is 9, and going on 8 years with D by her side. She's growing, and I pray she turns out with a great attitude like yours! : ) Hugs, Holly Thanks for sharing, Hallie!!

Stephanie Hi! This is Jen Loving's daughter Nora.I was dxd with T1D when i was 4 in a half years old and now I am 11 years old. I always ask the questions to myself 'Why me?' too. Now that I read this masterpiece of yours I am not. I KNOW YOU WILL GET VERY FAR IN YOUR LIFE!! :) I want to thank you for sharing your story with all of us!:) God Bless, Nora

Hallie, you are the amazing one! You reach so many people and really make a difference. One note: I was scared to death to send Stephanie to overnight Diabetes Camp, since I couldn't talk to her for a week and I wouldn't be in control of her diabetes care. She and I both cried when I dropped her off. I worried all week, but was comforted by the fact that there were doctors and nurses there to care for her. I worried that she was miserable and couldn't call me to talk about it. It was a very stressful week for me. Then...I went to pick her up a week later and she didn't want to leave camp. She cried when we left to go home. Her and her new friends made plans to meet up and plan for camp a year later. I was so relieved! I began to look forward to overnight diabetes camp along with Stephanie. Now for the past 7 years there has been a week where she feels "normal" and where I can relax knowing she is happy and well cared for in a way that surpasses how I could ever care for her. Dianne

Being a D mama of a 5yo I can imagine how proud your parents must be! You'll do great things in life for sure, you have the right attitude. Keep walking your head held high, you are a wonderful young woman! Thanks for sharing Stephanie Camille ;)

Well hi everyone! This is kind of surreal because the only person on here I've ever met is my mom...and you're all saying such nice things to/about me. I almost cried reading all of it. I'm so happy that my essay has had such an effect on everyone. I absolutely LOVE that I might be convincing people to send their kids to camp. (Do it! You will NEVER regret it!) I just wanted to thank you all for the kind words and thank Hallie for posting this. Tell Sweetpea I say hi :) Stay Diabetastic ;) -Stephanie

thank you for sharing :) kelly woods

Wow! Stephanie, you are a real inspiration. I can't wait to share your beautiful words with my 8 year old. Best of luck to you!

Well, thanks for the cry! Just beautiful!

thank you for sharing this! it is beautiful and inspiring and gives me such hope for my Emma's future. My favorite line is "I want to use my story to show people that your differences aren’t a weed you need to kill. They’ll flower into something amazing if you let them." Good luck to Stephanie in all of your future endeavors!

I really enjoyed reading that! No, I did not cry perhaps because I am a PWD. It was so heartfelt and real and lovely. I like this Stephanie person a lot!

Your blog is very useful and provides tremendous facts. Keep up the good work. best admission essay

Thanks for commenting! Comments = Love

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The experiences and support needs of students with diabetes at university: An integrative literature review

Virginia hagger.

1 School of Nursing and Midwifery, Deakin University, Burwood Victoria, Australia

2 The Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong Victoria, Australia

Amelia J. Lake

3 The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne Victoria, Australia

4 School of Psychology, Deakin University, Geelong Victoria, Australia

Tarveen Singh

Peter s. hamblin.

5 Western Health, St. Albans Victoria, Australia

6 Department of Medicine, Western Health, University of Melbourne, St. Albans Victoria, Australia

Bodil Rasmussen

7 Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen Denmark

8 Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Centre, Odense Denmark

Associated Data

Commencing university presents particular challenges for young adults with diabetes. This integrative literature review aimed to synthesise the research exploring the experiences and support needs of university students with diabetes.

Medline, CINAHL, PsychInfo and EMBASE databases were searched for quantitative and qualitative studies, among undergraduate and postgraduate students with type 1 or type 2 diabetes conducted in the university setting. Two reviewers independently screened titles, abstracts and full‐text articles. Data were analysed thematically and synthesised narratively utilising the ecological model as a framework for interpreting findings and making recommendations.

We identified 25 eligible papers (20 studies) utilising various methods: individual interview, focus group, survey, online forum. Four themes were identified: barriers to self‐care (e.g. lack of structure and routine); living with diabetes as a student; identity, stigma and disclosure; and strategies for managing diabetes at university. Students in the early years at university, recently diagnosed or moved away from home, reported more self‐care difficulties, yet few accessed university support services. Risky alcohol‐related behaviours, perceived stigma and reluctance to disclose diabetes inhibited optimal diabetes management.

Despite the heterogeneity of studies, consistent themes related to diabetes self‐care difficulties and risky behaviours were reported by young adults with diabetes transitioning to university life. No effective interventions to support students with diabetes were identified in this setting. Multilevel approaches to support students to balance the competing demands of study and diabetes self‐care are needed, particularly in the early years of university life.

• Young adulthood is a period of multiple life transitions.
• There is a lack of information about the needs of students with diabetes at university.
• This integrated review identified consistent themes in the literature. Students perceive more difficulty managing diabetes at university and may engage in risky behaviours to avoid appearing different to their peers. Multilevel intervention is needed to support students to adapt to university life.

1. INTRODUCTION

Young adulthood represents a challenging life stage for people with diabetes. Young adults are dealing with multiple transitions simultaneously, including developmental changes, increasing independence, transition to adult healthcare and university, or work, and for those who are newly diagnosed the transition from wellness to chronic illness. 1

Around 40% of school leavers in the United Kingdom and Australia start university, and others commence undergraduate or postgraduate study later. 2 , 3 The transition to university may involve independence from parents, leaving home, new relationships, experimenting with drugs and alcohol. 4 , 5 , 6 Students must learn to navigate classes and new routines, and find strategies to manage exercise, food and social activities, and for school leavers with diabetes, there is an added complexity to avoid and manage hypoglycaemia in a different environment. 1

For some young adults, managing diabetes is perceived to be harder at university than it was at school. 4 , 7 In a study from the United Kingdom, 26% of students with type 1 diabetes self‐reported a diabetes‐related hospital admission while at university, including 16% admitted for diabetic ketoacidosis (DKA) and 10% experienced severe hypoglycaemia requiring assistance. 4

Living with diabetes also impacts the social aspects of university life. A survey among first‐year college students in the United States found those with a chronic illness reported greater feelings of loneliness and lower quality of life (QoL) than their peers. 8 Most students knew no others with chronic illness, few disclosed their condition or registered with campus disability support services. Moreover, youth with chronic illnesses may be less likely to graduate from university than their peers. 9 Feeling socially isolated and unsupported may contribute to lower academic success and suboptimal health outcomes for young people with a chronic condition. 8 University support services (often referred to as disability or accessibility support) aim to minimise the impact of disability and health conditions on academic performance and outcomes, yet few students with diabetes access such support. 4

Interpersonal and self‐care concerns such as these are often reported among adolescents and young adults with diabetes. 10 , 11 However, commencing university typically coincides with new freedoms and independence, and the structures and environment may present specific barriers to self‐care. A better understanding of the unique self‐care challenges for university students with diabetes could inform appropriate strategies that enable students to achieve their health and academic goals. Primary research has explored experiences of university students with type 1 diabetes, 4 , 7 , 12 but some of these studies are small, 13 , 14 or focus on a single facet of student life. 15 , 16 Despite increasing prevalence of type 2 diabetes in young adults, few studies have considered their concerns in this setting. 15 Therefore, this literature review aimed to identify and synthesise the research to provide a comprehensive perspective of the university experience for students with diabetes and better understand their support needs while at university.

An integrative literature review was undertaken to incorporate primary studies with diverse methodologies and comprehensively portray the topic, following the six‐step, systematic process described by Toronto and Remington: identify purpose and scope; systematic search using predetermined criteria; quality appraisal of selected literature; data analysis and synthesis; critical discussion; and dissemination of findings. 17

2.1. Inclusion and exclusion criteria

Included in the review were studies among undergraduate and postgraduate students diagnosed with type 1 or type 2 diabetes, reporting the student experience of living with diabetes or supportive interventions conducted in the university setting. We excluded studies not specific to diabetes, among children and adolescents, that reported only clinical outcomes or service delivery, or conducted in schools, hospitals or community settings. Limits were applied for language (English only) but not for date of publication.

2.2. Search strategy

A list of search terms was defined using a combination of subject headings, keywords and phrases and modified for each database. Following preliminary searches that included synonyms for interventions, outcomes and participant perspectives, only terms for ‘diabetes’, ‘students’ and ‘university’ were retained. For the full search strategy, see Table  S1 . Medline, CINAHL, Psych Info and EMBASE databases were searched 25 June 2020, and reference lists and citations of included papers checked. The Cochrane database was searched for previous reviews. The search was rerun 17 May 2022 to include the most recent publications. Search results were imported into Covidence™ database and duplicates removed. Two researchers (V.H. and T.S.) independently screened the titles and abstracts and selected full‐text articles. Discrepancies were resolved by consensus.

2.3. Quality appraisal

Study quality was appraised using the McMaster University Critical Review Forms for Quantitative Studies 18 and Qualitative Studies. 19 Two reviewers (V.H., T.S.) assessed 20% of papers independently and discussed methodological limitations. The remaining papers were assessed by one reviewer (V.H.). One author was contacted to correct data. 20

2.4. Data abstraction, analysis and synthesis

Data were extracted and recorded in an Excel spreadsheet (T.S.) which was first piloted and revised. A second reviewer (V.H.) re‐read all papers and checked data for completeness. Data were analysed and synthesised thematically, using an inductive approach described by Braun and Clark to identify patterns in the content. 21 This involved re‐reading articles, identifying initial codes, summarising and organising study results into themes and subthemes, which were re‐examined and refined iteratively. Results were reported using a narrative approach in order to present heterogeneous data in a cohesive, readable format. 17 , 21

We utilised the ecological model to guide the interpretation of results and for making recommendations to strengthen student support. 22 This model focuses on interactions between individuals and the sociocultural and physical environment, 22 and was adopted by the American College Health Association for campus health promotion. 23 We applied McLeroy et al.'s model, 24 which portrays five levels of influence on health behaviour: intrapersonal factors (e.g. demographic, psychological), interpersonal factors (e.g. family, social networks), institutional factors (e.g. rules, regulations, schedules), community factors (e.g. built environment, transport) and public policy (e.g. policies, legislation).

In this manuscript, ‘university’ includes tertiary colleges. Most studies only involved type 1, so ‘diabetes’ is used for brevity. ‘Self‐care’ encompasses health behaviours, taking responsibility for health and healthcare and managing emotions. 25

The database search located 3372 articles. No additional papers or reviews were located. After screening titles and abstracts, 137 full‐text articles were retrieved and critiqued against the inclusion and exclusion criteria. Twenty‐five articles (20 studies) were included in the review. In two cases, several papers described the same study and reported different outcomes. 12 , 26 , 27 , 28 , 29 , 30 , 31 In these instances, we nominated the earliest publications as the primary source, 12 , 30 retaining the secondary papers. The PRISMA diagram in Figure  1 shows the reasons for exclusion.

PRISMA diagram. Search results and reasons for exclusion.

3.1. Study characteristics

There were 10 qualitative studies used focus groups, 1 , 14 , 32 individual interviews 6 , 12 , 15 , 32 , 33 , 34 , 35 or online forums 36 to explore student experiences and self‐care. Nine cross‐sectional studies examined: diabetes management, 4 , 5 , 7 , 30 , 37 alcohol‐related behaviours, 16 , 30 perceived health, 20 mental health, 31 perceived stress, coping and self‐care 38 and QoL. 13 , 30 One quasi‐experimental study examined knowledge and attitudes to alcohol. 39 Fourteen studies were conducted in the United States; three in England; and one each in Ireland, Norway and Canada. Sample sizes ranged from 9 to 25 in qualitative research, and 25–584 in quantitative studies. All papers were published since 1997; 12 within the last 10 years, and seven between 10 and 25 years. Table S1 shows study details.

3.2. Recruitment

Participants were recruited through flyers or campus newsletters, 14 , 15 , 32 , 34 , 39 College Diabetes Network (CDN), 1 , 13 , 20 , 34 , 39 email 4 , 6 , 14 , 33 , 38 or mailed questionnaire, 7 medical clinics, 4 , 12 , 32 , 37 social media 39 and Diabetes UK website. 4 One study analysed publicly available online data, 36 two accessed national student health survey data 5 , 16 and one did not report recruitment method. 35

3.3. Participant characteristics

In 16 studies, participants had type 1 diabetes. 1 , 4 , 6 , 7 , 12 , 13 , 14 , 20 , 30 , 32 , 33 , 34 , 35 , 37 , 38 , 39 One included students with type 1 and type 2 diabetes 15 and the type of diabetes was unknown in three studies. 5 , 16 , 36 Most studies included undergraduate and postgraduate students, 1 , 4 , 5 , 6 , 12 , 14 , 20 , 30 , 32 , 34 , 38 , 39 ; five focused on undergraduates, 7 , 13 , 16 , 33 , 35 and in three, graduate status was not reported/unknown. 15 , 36 , 37 Participants ranged in age from 17 to 40 years, although most studies included young adults (18–30 years) and participation was typically higher among women than men. Four to 22 per cent of participants were from minority ethnic groups (where reported) (Table  1 ).

Table of included studies

Note : Minority (populations): Non‐European/White. Theme 1: Barriers to self‐care at university; 2: Living with diabetes as a university student; 3: Identity, stigma and disclosure; 4: Strategies for managing diabetes at university.

Abbreviations: CDN, College Diabetes Network; NR: not reported; T1DM, type 1 diabetes; T2DM, type 2 diabetes.

3.4. Quality assessment

Among quantitative studies, potential sources of bias were representativeness, 7 , 13 , 16 , 20 , 36 , 37 , 38 small sample size (<50 participants), 7 , 13 the use of unvalidated questionnaires 20 , 39 and self‐reported data. 4 , 5 , 7 , 16 , 20 , 30 , 37 , 38 , 39 Transferability may be limited for some qualitative studies, 1 , 12 , 14 , 15 , 33 , 34 , 35 , 36 and one had fewer than 10 participants. 14 Data analysis was not well explained in two studies. 32 , 35 Refer to Table  1 for details of study limitations.

3.5. Study themes

Four major themes were identified: barriers to self‐care at university; living with diabetes as a university student; identity, stigma and disclosure; and strategies for managing diabetes at university. Table  2 lists the major themes and 18 subthemes. Figure  2 represents themes according to the Ecological model.

Study themes

Ecological model. Adapted from McLeroy et al. 24 Factors influencing health behaviours for university students living with diabetes.

3.5.1. Barriers to self‐care at university

Managing diabetes was perceived to be more difficult at university than high school. 4 , 7 The first few months may present the greatest challenges, as students adapt to university life. 33 , 36 However, among UK students with type 1 diabetes, difficulties were not limited to younger students and women perceived more problems with diabetes self‐care than men. 4 Female students reported higher HbA 1c 4 , 30 and diabetes distress than males, 31 and diabetes distress was higher among older than younger students. 31 For recently diagnosed students, learning to manage diabetes made the transition to student life more complex. 1 , 4 , 27

Lack of structure and routine

Uncertainty and lack of control over situations at university frustrated students' efforts to manage their blood glucose levels optimally. In contrast to the school environment, the lack of structure and routine, such as irregular class timetables and mealtimes, interfered with maintaining a self‐care routine. 1 , 4 , 7 , 13 , 27 , 32 , 36 Insufficient time to check blood glucose and eat between classes 35 and difficulty balancing study and diabetes resulted in some students skipping classes or blood glucose checks 34 or not testing at all. 29 Self‐care routines of first‐year students often ‘slipped’ due to staying up late, partying and studying. 27 Living in student accommodation provided some structure but moving off‐campus could be problematic for students who lacked the necessary self‐care skills. 27 Balancing study, social life and blood glucose levels was described as a constant concern, 13 , 14 , 33 with students feeling guilty when their routine and diabetes management were affected. 27 Students learnt to adapt as they progressed through university, but experienced ‘glitches’ at different times, for example, during periods of stress or exams. 27 Recently diagnosed students experienced more difficulty establishing self‐care routines in the university environment than those diagnosed at an earlier age, 1 , 4 , 27 and adapted by structuring their lives or disregarding self‐care. 27 In Kellett et al.’s study, 13% of participants were diagnosed while at university. 4 These students had more difficulty managing mealtimes, food and exercise than those diagnosed prior to university.

Food and eating

Several food‐related factors were perceived to affect self‐care. Eating patterns were altered 7 and appropriate food choices were limited on campus. 1 , 4 , 14 , 32 , 33 , 36 Nutrition information about carbohydrate content was unavailable for food in the cafeteria, limiting accurate estimation of insulin doses. 13 , 14 , 36 Take‐away food and eating out was a normal part of student life but impacted glycaemia. 36 Needing to carry food and eat in class was inconvenient. 32 Food was prohibited in some areas on campus, for example, the library, examination or laboratory rooms, resulting in students missing or leaving class to manage hypoglycaemia. 1 , 14 While some students would approach the lecturer to explain their needs, others were reluctant to draw attention to their diabetes. 14

Self‐care support

Students reported feeling less supported to care for their diabetes at university than at school. 14 They had more autonomy but lacked guidance and support from their parents, 4 , 7 , 33 , 34 particularly when living away from home. 4 , 27 Students remained with their usual diabetes care team more often than transferring to local healthcare, even when moving away from home. 4 , 33 However, being unable to travel home and clashes with university timetables were barriers to attending clinic appointments. 4 , 33 , 35 Kellett et al. found that students who transferred their medical care reported higher HbA 1c , more frequent hypoglycaemia, hospital admissions and DKA than those who remained with their home specialist team. 4 Among this group, diabetes management was more likely to be impacted by alcohol, exercise and weight‐related issues. 4

Fear of hypoglycaemia

Fear of hypoglycaemia was a barrier to optimal diabetes management in four studies. 7 , 14 , 32 , 35 Hypoglycaemia or checking blood glucose might draw attention, so some students reported intentionally maintaining elevated blood glucose, 14 , 35 for example, by taking less insulin. 35

Other barriers

In four studies, students reported academic‐related stress (e.g. assessment, performance) negatively affected glycaemia. 4 , 14 , 32 , 34 Perceived general stress was associated with less frequent health behaviours (healthy eating, footcare), but positive coping skills (e.g. positive reframing, planning) predicted more frequent self‐care in one study. 38 Disturbed sleep from attending to diabetes or being woken by pump or glucose monitor alarms also impacted blood glucose levels. 1 Using a scale developed to measure attitudes and behaviours associated with diabetes self‐care at university, Widowik demonstrated that situational factors, such as social events, peers, competing priorities, stress and negative emotions, were negatively associated with self‐care. 37 Other barriers cited were finances, use of drugs and alcohol, peer pressure, disordered eating and skipping insulin. 7 Financial difficulties were also associated with high HbA 1c . 30

3.5.2. Living with diabetes as a university student

Alcohol and risky drinking.

Alcohol was a normal part of university life for young people and students drank at bars, clubs and parties. 15 , 26 Drinking alcohol was considered one of the main social activities at university and there was strong peer pressure to drink. 15 , 33 However, diabetes was perceived a barrier to socialising at university. The pressure to drink alcohol caused some students to avoid going out of an evening whereas others might forget diabetes and enjoy themselves. 35 Drinking alcohol enabled young people to develop their student identity and to appear ‘normal’, and when their condition was known, to appear capable and in‐control and not limited by diabetes. 26 Some students experimented with alcohol, testing the effect and their own limits. 15 Others limited drinking to maintain control of themselves, their diabetes or body weight and to avoid hypoglycaemia. 15

In three studies, students with diabetes described consuming alcohol at the same risky level as their peers without diabetes. 5 , 16 , 26 Cockroft et al. found that 70% of all students exceeded the recommended alcohol limits for age and gender and 42% engaged in binge drinking. 5 However, the students with diabetes used fewer protective strategies and were more likely to drive when drinking, and experience academic problems due to alcohol. Additionally, more students with diabetes reported treatment for substance use than those without diabetes. 5 In another study, 42% of students with diabetes reported drinking at excessive levels (≥5 in one sitting), and 37% (mostly younger students) reported one or more consequences of alcohol in the past year including injuring themselves, later regretting behaviour and forgetting what happened. 16 In contrast, fewer students with diabetes reported alcohol problems and harmful alcohol use than students without diabetes in a Norwegian cohort. 31 Students were aware that alcohol was a risk to their diabetes management, 7 , 26 , 39 future health and ability to work. 26 In one study, students had high self‐reported knowledge, but moderate concerns about the impact of alcohol on diabetes. 39

Alcohol‐induced hypoglycaemia threatened a ‘normal’ student identity and their independence if it occurred in public, but students were less anxious about hypoglycaemia occurring at home, believing they could deal with it themselves or be looked after by friends. 26 Older students transitioned to less risky drinking as their adult identities and social networks were more established and they were more cognisant of the risks to their health. 16 , 26

Students associated managing diabetes well with having a healthy body 34 and better self‐esteem. 28 In a UK study, students with type 1 diabetes perceived social pressure to maintain a slim and healthy body and control their condition through disciplined eating and exercise. 12 , 26 , 27 , 28 , 29 Men identified the desire to feel fit and healthy through sport and well‐controlled blood glucose, whereas women were concerned with body image but felt their attempts to lose weight by exercising were thwarted by hypoglycaemia. 12 Lower body weight satisfaction and unsafe weight loss strategies were more likely to be reported by students with diabetes than those without the condition. 5 Norwegian students with diabetes reported higher body mass index, 30 and lower QoL than students without diabetes, 31 but no difference in physical activity, 30 mental health, loneliness, sleep and health symptoms. 31 Some students reported adopting more healthy eating behaviours after learning about the consequences of disease in their course. 26

Impact of diabetes on academic performance

Fluctuations in blood glucose could cause fatigue and poor concentration in class, 14 difficulties completing assignments and exams and affect vision and driving. 33 , 34 Hypoglycaemia necessitated consuming food or drink to prevent or treat an episode, sometimes causing students to be late or miss classes. 33 , 34 A national college health survey in the United States found that students with diabetes had a lower grade point average (GPA) than those without diabetes and were more likely to perceive that sleep problems, disordered eating and alcohol affected their academic performance. 5

Lack of diabetes awareness

Students commented on the lack of understanding about diabetes in the community, among peers, lecturers and the media. 6 , 14 Others found peers and the public overly intrusive and offered unwelcome advice, particularly around food. 1 Some students reported neglecting self‐care in public to avoid constantly explaining their diabetes to others, 14 whereas others believed they had a responsibility to use these interactions to educate the community about diabetes. 1 University staff, including health staff, were perceived to lack knowledge about diabetes and students' needs. 33 , 36 Students felt unconfident about receiving emergency assistance for severe hypoglycaemia at university and felt less safe than at school where pupils with diabetes were well known and resources available. 14

Autonomy and growth

In six studies, students reported the positive aspects of living with diabetes. Diabetes was not perceived to deter achievement 34 and was frequently reported as a challenge that led to personal growth and maturity. 6 , 7 , 14 , 34 , 36 Going to university was an opportunity to develop independence and master diabetes self‐care, 36 and assume self‐responsibility for health. 1 In two studies, students reported optimism, enjoying life and relationships with their peers with diabetes. 1 , 34 Compassion for others was identified as an attribute of living with diabetes, 1 and some students were motivated by their condition to choose a health‐related career. 34

Worry about the future

Concerns were expressed about the impact of the student lifestyle on diabetes management and future complications. 13 , 34 , 36 As students considered life after university, they worried about gaining employment and finding a life partner that could deal with diabetes. 13 Students in the United States identified concerns about insurance and the cost of diabetes care. 13 , 32 , 36

3.5.3. Identity, stigma and disclosure

Student identity.

Students described not wanting to be different to their peers or defined by diabetes. 1 , 12 , 26 They behaved in a number of ways to maintain a ‘normal’ student identity on campus, including participating in exercise, not limiting food intake, risky drinking of alcohol, 12 , 26 staying up late and partying. 1 Checking blood glucose or treating hypoglycaemia in class could be embarrassing or invite criticism. 14 Some students reported maintaining an elevated blood glucose level to avoid these situations which would draw attention to having diabetes. 14 , 26 , 35

Diabetes stigma and telling others about diabetes

Common misunderstandings and stereotypes, for example, attributing diabetes to unhealthy lifestyles, was a constant source of stress and frustration for students with type 1 diabetes, 6 , 14 and they perceived these misconceptions reduced the level of emotional support they received within social relationships. 6 Students avoided disclosing their diabetes if they anticipated a negative reaction, such as rejection or discrimination, were made to feel different, explain diabetes or receive unsolicited advice. 6 , 14 , 29 , 32 Some female students perceived stigma around using needles. 29 Older students, particularly men, were less concerned about diabetes‐related stigma and conforming to a student identity and stated they felt comfortable testing and injecting in public. 29 Habenicht et al. also found the reasons for disclosing diabetes varied by gender. 6 Despite claiming openness, some men avoided disclosure because it may elicit pity, making them feel ‘weak’, whereas women told others about their diabetes to build trusted relationships and to be responsible.

Students usually felt comfortable disclosing diabetes for safety reasons, for example, to elicit support when needed or going out, 6 , 34 and might tell others to avoid pressure to drink alcohol. 15 For some students, performing self‐care in front of others was a mean to passively disclose diabetes, which might initiate a casual conversation about the condition. 6 Sharing their diagnosis was seen as a way to educate people about diabetes. 34 Over time, most students learnt to advocate for themselves and their health in the face of peer pressure and for adjustments to manage their diabetes and study. 1

3.5.4. Strategies for managing diabetes at university

Preparing for university.

Concerns for students preparing for university included access and storage of supplies, 33 , 34 , 36 health insurance, avoiding hazardous situations, dealing with hypoglycaemia and finding new health professionals. 36 Both young people and parents expressed concerns about students moving away from home and being without parental support, 1 , 4 , 36 which influenced university choices for participants in one study. 1 Students indicated they sought a supportive roommate, for example, one who could tolerate disturbed sleep and provide support with hypoglycaemia. 1 Most students in one study indicated they received information about diabetes management when preparing for university, but relevant resources, such as sexual health, mental health or substance use, how to access medical and disability support and flexible insulin adjustment were not regularly provided. 4

Forward planning

Students learnt to adapt their diabetes self‐care to the flexible university environment, which could involve long days and irregular schedules. 1 They recognised the need to plan ahead to manage blood glucose levels during classes, exams, exercise and social activities, deal with the effect of stress and avoid running out of diabetes supplies. 34 One risky forward planning strategy sometimes used, involved taking less insulin to maintain elevated blood glucose and avoid hypoglycaemia. 14 , 35

Obtaining support

Despite the diabetes management difficulties experienced by students, Kellett et al. found that few (9%) contacted university support services for advice or support. 4 Reported barriers to accessing support include lack of diabetes knowledge and understanding among campus staff 33 , 35 and failure of staff to make appropriate allowances for diabetes. 35 Participants in one study stated they did not feel disabled or want special privileges to succeed, 14 although in another study, students preferred to register for learning support than to individually approach lecturers for allowances. 1

Friends, particularly friends with diabetes were an important source of peer and diabetes self‐care support 6 , 20 , 32 , 33 , 34 and lessened feelings of isolation, 20 , 33 , 34 depression and anxiety. 20 Around half of students in one study wanted to meet other students with diabetes or join a peer support group. 32 Peers with diabetes understood the lived experience, 6 , 34 and such support was accessed via online forums, social media and the CDN. The CDN is a USA‐based national advocacy organisation providing events, online diabetes information and newsletters about preparing for, living and studying at university. 20 , 40 On occasion, the CDN assisted with emergency diabetes supplies. 34 A survey found that CDN members were more likely to access disability allowances than non‐members. 20

Students relied on friends and roommates to assist them during emergencies, teaching them what to do, such as administer glucagon or call emergency services in the event of severe hypoglycaemia, 1 , 6 , 13 although some had no supports in place for dealing with hypoglycaemia. 7 Being surrounded by people without knowledge of their diabetes afforded privacy and autonomy, but no ‘safety‐net’, challenging young adults to become more independent. 14 Parents were usually the main source of diabetes self‐care support and their ongoing involvement was valued, 4 , 6 , 34 , 36 although parental support was less accessible after moving away from home, which could lead students to paying their diabetes less attention. 6 For students who perceived their parents were over‐involved in their diabetes, going to university was an opportunity to achieve independence. 34

Using technology

Diabetes technology such as insulin pumps and glucose monitoring enabled greater flexibility with the social aspects of student life, dealing with stress and the unstructured university environment. 29 Students using an insulin pump found alcohol easier to manage. 15 , 29

Using technology allowed some students to feel and appear ‘normal’. 29 In contrast, others felt technology made their diabetes visible, so avoided checking blood glucose or injecting insulin in public. 26 These concerns were expressed more often by younger and female students due to perceived diabetes stigma and the effect of wearing technology on appearance. 29

Alcohol management strategies

In online posts, students reported incidents of severe hypoglycaemia due to alcohol but not knowing how to manage their diabetes when drinking. 36 Drinking habits may not be regularly discussed with healthcare professionals. 15 , 39 Students used a variety of methods to moderate the risks of alcohol and having strategies in place predicted less drinking and fewer consequences. 16 Strategies included eating before and/or after drinking, 15 , 16 , 26 , 32 avoiding parties and bars, 15 socialising but not drinking alcohol, 1 , 15 , 16 , 26 having personal rules about the type and amount of alcohol they can safely consume, 15 , 39 avoiding drinking games, pacing or keeping track of drinks, 15 , 16 choosing drinks with sugar or sugar‐free, 26 taking insulin to cover alcohol, 15 , 32 monitoring blood glucose 15 , 26 , 39 and drinking with friends. 39 Friends were helpful by either not pressuring them to drink or by assisting in an emergency. 15 Short‐term improvements in binge drinking, knowledge, attitudes, concerns and intentions were reported after alcohol and diabetes education. 39

4. DISCUSSION

This first integrated literature review about students with diabetes at university identified consistent patterns in the concerns and challenges for young adults and highlighted features of the university environment that present barriers to self‐care. These themes will be discussed according to the ecological model, including implications for future research and practice, and recommendations for multilevel support that can be adopted by health professionals and tertiary education institutions.

4.1. Intrapersonal factors

Managing diabetes may not be easier for students as they get older. Diabetes distress was higher among students aged 24–29 than 18–23 years, 31 a trend also found in the DAWN2 study, with the older group feeling more overwhelmed and less supported. 41 Diabetes distress characterises many of the concerns and feelings expressed by students, and affects around one‐third of young adults with diabetes. 42 It is encouraging that mental health problems were not more prevalent and students with diabetes were as physically active as their counterparts without diabetes, but QoL was lower, most likely related to the specific burden of diabetes. 43 , 44 Women perceived more difficulties and distress than men, which is a consistent finding from adolescence onwards. 45

Students perceived diabetes affected them academically. One study reported slightly lower GPA, 5 which could influence future socioeconomic and health status. However, a small study among school leavers found no difference in workforce participation, higher education or GPA with or without diabetes. 43 Acute glycaemic excursions can impair cognitive performance, 46 and elevated HbA 1c is associated with lower academic achievement among adolescents. 46 , 47 While academic stress may cause short‐term fluctuations in glycaemia, students with prolonged suboptimal glycaemia are also more likely to experience diabetes distress and mental health problems 31 and students with mental health‐related, 48 or more than one disability, are less likely to graduate than other students. 49 For those from disadvantaged backgrounds, financial pressures to work or stress may further affect self‐care 30 and attention to study, while already confronting psychological and material barriers to success at university. 50 Students experiencing prolonged stress and distress could benefit from ongoing academic, financial and psychological support. Students diagnosed shortly before or while at university also need support to develop problem‐solving skills usually acquired in adolescence. 51

4.2. Interpersonal factors

Students experienced social concerns reported by young adults with diabetes elsewhere, namely, body image and unwillingness to disclose diabetes due to perceived stigma and unwanted attention. 41 , 44 , 52 These mindsets diminish with age but can intensify during transitions to new environments and with new social groups and present a barrier to self‐care in these situations. 44 Better community awareness may help to lessen the negative consequences of diabetes stigma, which disproportionately affects women. 53

Similar rates of binge drinking of alcohol are reported among youth with and without diabetes, 5 , 16 , 26 , 43 although student culture and peer pressure encourage underage, and risky drinking in the university setting. 15 , 33 , 54 Without parental surveillance, alcohol and drugs present a greater risk for students with diabetes living out of home. In a study of underage drinking at university, alcohol marketing, rewards (e.g. relaxation, getting drunk) and education predicted higher alcohol intake, 54 whereas, enforcing alcohol control policies, 55 skills‐based and motivational interventions may reduce alcohol consumption. 54 Psychoeducation interventions focused on harm reduction among students are likely to be more influential than general awareness of alcohol and diabetes. 39

As young adults transition to university or work, parental monitoring and involvement decreases and often HbA 1c increases, but this may be mitigated by developing problem‐solving skills, 51 and ongoing parental support. 56 Friends and partners may take over providing emotional and practical support. The CDN has over 140 Chapters in the United States, offering peer support and information tailored to students with diabetes. 40 Although CDN resources are accessible, they are tailored to the USA context.

4.3. Institutional factors

Students with diabetes are entitled to reasonable adjustments to accommodate diabetes, for example, access to food and extra time for exams. Accessing support is associated with higher odds of graduating for students with disabilities. 48 However, few students with diabetes take advantage of this support, and institutional barriers to accessing services include staff attitudes, appropriateness of accommodations and communication about disability services. 57 Students relied on friends and roommates in emergencies, yet institutions have responsibilities to ensure students living on campus are safe and should have policies in place. 58 Students living independently need to consider strategies for checking their well‐being, in contrast to school or the workplace where attendance is monitored.

4.4. Community factors and public policy

The community level includes campus facilities, such as cafes, meal services and alcohol outlets. Adapting to these factors requires preparation and planning skills that emerge with maturity. At the policy level, anti‐discrimination legislation obliges universities to provide adjustments to enable students to fully participate in their education. 59

4.5. Limitations and strengths

There are several limitations to this research. We restricted publications to the English language which could have omitted relevant studies. In most studies, participants had type 1 diabetes, were aged under 30 years and more likely to be female, so the results may not be generalisable. We included type 2 diabetes in our search but located only one paper and none in students over the age of 40. Several studies recruited through the CDN so likely to represent more socially connected students. There were no studies that could demonstrate effective interventions to support students and few studies considered socioeconomic or racial background; factors likely to increase disparities for students with diabetes. We were unable to synthesise the data quantitatively due to the heterogeneity of studies. Nevertheless, the review was rigorously conducted following Toronto and Remington's methodology, 17 and we were able to incorporate the available evidence from different study designs, the findings of which were highly consistent. Most studies were conducted in the United States where students typically leave home to attend university and the legal drinking age is high compared to other countries (21 years). 54 These two factors may influence alcohol‐related and self‐care behaviours, so some findings may not be transferable to all settings.

4.6. Future research

There are gaps in the literature about students with type 2 diabetes, older adults and those from ethnic minorities or attending technical colleges who may experience socio‐economic disadvantage. The needs of students with complications should be explored. Further understanding is needed of the barriers to accessing disability services and student preferences for support and whether such support improves outcomes, as are evidence‐based interventions to minimise alcohol risk for students with diabetes. Outcome evaluation of support programmes such as CDN could help to advocate for establishing such programmes elsewhere.

4.7. Implications for policy and practice

Most student concerns identified in this review are experienced by young adults with type 1 diabetes. However, problems are exacerbated during life transitions and interactions with the university environment. Support could be enhanced at multiple levels.

4.7.1. Intrapersonal

Female students, students with mental health problems or those from ethnic minority or disadvantaged populations, are likely to have more problems dealing with their diabetes and to benefit from disability, academic and psychological support while at university.

4.7.2. Interpersonal

Institutions could improve understanding of diabetes in their community to minimise stigma.

4.7.3. Institutional

Institutions could monitor academic outcomes and ensure disability services are accessible and tailored for diverse students, living on‐ and off‐campus and different types of diabetes, and promote engagement. Health professionals and universities could provide evidence‐based practical information about alcohol and drug safety.

4.7.4. Community and policy

Organisations such as CDN could advocate and provide information tailored to the student experience at a campus, state or national level.

5. CONCLUSIONS

This integrated review of published studies identified consistent themes about diabetes self‐care difficulties and risky behaviours were reported by young adults with diabetes after moving from school to the less structured university setting. Some students need support to manage their diabetes in this environment and self‐care resources tailored to university lifestyles, paying particular attention to the early years at university, those leaving home or recently diagnosed with diabetes. These findings provide a foundation for the development of resources and interventions tailored to the needs of this priority population. Further research into the experiences and support needs of older students, those from diverse backgrounds and type 2 diabetes would address gaps in the literature.

AUTHOR CONTRIBUTIONS

Virginia Hagger designed the study, conducted the review and drafted the first version of the manuscript. Tarveen Singh assisted with searching, appraisal and data extraction. Bodil Rasmussen, Amelia J. Lake, Peter S. Hamblin contributed to the review design, search strategy and critical revisions to the manuscript.

CONFLICT OF INTEREST

The authors declare no conflicts of interest.

Supporting information

Acknowledgement.

This project was supported by funding from the Australian Diabetes Educator's Association Diabetes Research Foundation. Open access publishing facilitated by Deakin University, as part of the Wiley ‐ Deakin University agreement via the Council of Australian University Librarians.

Hagger V, Lake AJ, Singh T, Hamblin PS, Rasmussen B. The experiences and support needs of students with diabetes at university: An integrative literature review . Diabet Med . 2023; 40 :e14943. doi: 10.1111/dme.14943 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

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Going to College with Type 1 Diabetes

Published July 26, 2023 in Awareness , Life with T1D

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Heading off to college can be both exciting and scary. Having type 1 diabetes (T1D) adds another level of concern for both students and parents. We’ve compiled a list of practical tips to help you succeed in college with type 1 diabetes!

Before You Go to College:

• Download our Quick Start Guide to Living Independently with T1D.
• Talk to your parents about setting up Medical Power of Attorney and HIPAA Right of Access Document so that they can stay informed and make health care decisions for you in case of emergency.
• Talk with your endocrinologist for advice on carb counting in the dining hall, managing stress, and how to stay safe when drinking alcohol.
• Bring a 3-month supply of low blood sugar supplies. They will go quicker than you think!
• Bring plenty of insulin, pump, CGM, and testing supplies. Also, bring back-up supplies in case of a pump or meter failure.
• Find a local pharmacy and/or arrange for mail-order prescription refills.
• Create a sick-day kit. Include ketone test strips, glucagon, a prescription for treating nausea/vomiting, Tylenol or aspirin, sugar-free cough and cold medicines, saltines, Gatorade, etc.
• Contact the Office of Disability Services. They will be your best resource for ensuring you have the accommodations you need for a successful college career.
• Emergency contact information (parent/guardian, doctor, caregiver)
• Pharmacy telephone number and prescription information
• Information about treating high and low blood sugar. (Download our printable handouts on high blood sugar and low blood sugar .)
• Information on how to use glucagon . You can even tape your glucagon to the folder for quick access! And be sure to keep your glucagon in an easy-to-find location.

When You Get to College:

• Choose the bottom bunk. This will make it easier for you to treat highs or lows at night.
• Keep low blood sugar supplies right next to your bed (with a flashlight) so you can treat nighttime lows without disturbing your roommate.
• Keep your supplies organized so that they are easy to get to and you’ll be able to find what you need quickly.
• Let the people around you know you have T1D. Roommates, dormmates, resident advisors, and professors should know that you have T1D and how to help you if you have low or high blood sugar.
• Let roommates and dormmates know that your juice boxes and low blood sugar snacks are off-limits to them.
• Always carry low blood sugar supplies with you. You can’t count on finding a vending machine in every building.
• Wear a medical ID. If there is ever an emergency, paramedics will immediately know they are dealing with a person with T1D.
• Learn about your college’s mental health services. College is stressful and it’s not unusual for students to experience anxiety and depression when they are on their own for the first time. T1D increases that risk and knowing where to go for help before you need it makes it much easier to get help.
• Communicate with your worried parents. They will be adjusting, too! (Parents, download our guide Help Your Teen Transition from Dependence to Independence .)
• Connect with the JDRF Chapter near your college or university .

More Resources:

You can find more great advice and resources from some of our T1D community partners:

• The Diabetes Link – Provides young adults with T1D the peer connections they value, and expert resources they need, to successfully manage the challenging transition from life at home to independence at college.
• T1D College Packing List
• Scholarships for people with type 1 diabetes
• Navigating the dining hall with T1D

Being prepared will ensure you have a fun and exciting experience in college. We wish you success and happiness on campus and beyond!

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Dealing with Diabetes in College

BY KATHY KATELLA August 19, 2019

The day Yale senior Gabriel Betancur took the MCAT, the eight-hour medical school admission test, the sensor he wears taped to his arm to track his blood sugar levels sent data to his cellphone that showed his blood sugar was rising.

As anyone with type 1 diabetes knows, high blood sugar causes symptoms, including fatigue, thirst, and frequent urination.

“I powered through it,” says Betancur, adding that he might not advise someone else to try the same thing. “Maybe I should have taken the test on another day, but it all worked out.” Betancur passed the exam and was accepted at Yale School of Medicine; his dream is to become a pediatric endocrinologist.

It was a tough day, but nobody said higher education would be easy with type 1 diabetes . “We know, looking at the data, that achieving targeted glycemic control is difficult for many teens and young adults, and it’s a problem that can affect health long-term,” says Jennifer Sherr, MD, PhD , a Yale Medicine pediatric endocrinologist who is Betancur’s doctor and has type 1 diabetes herself. “Many studies are focused on how to improve care for this age group, in particular.”

Achieving targeted glycemic control is critical to prevent such long-term complications as cardiovascular disease , kidney disease, and retinopathy. Children up to age 18 are advised to target an A1c level (a 3-month measurement to estimate the average level of blood sugar) of < 7.5, and that should decrease to about 7 in adulthood.

Yet, the data from the Type 1 Diabetes Exchange Clinic Registry, a consortium of over 80 centers across the United States, shows that the average A1c in young people with diabetes (ages 13 to 26) is about 9, putting these teenagers and young adults at risk for complications later in life.

Betancur says it was a shock for his family when he developed severe stomach problems at the age of 4 and was diagnosed with type 1 diabetes. With this condition, the immune system mistakenly destroys the cells in the pancreas that produce insulin, the hormone that regulates glucose, or blood sugar. (This is different than type 2 diabetes , which is typically diagnosed in middle-aged or older people whose bodies don’t metabolize insulin properly.) Blood sugar is vital because it gives the body energy.

Managing diabetes on their own

Because management of the disease is critical, it’s that much more complicated for students going off to college, who are away from their parents, the comforts of home, and even their doctors.

College students with type 1 diabetes must be prepared for their new environment, says Dr. Sherr: “They need equipment and supplies for injecting or pumping insulin. A refrigerator for storing it is mandatory, as are such items as juice boxes, glucose tablets, granola bars, and maybe some kid-sized candies for a boost when their blood sugar is low.”

Once college students are settled on campus, new triggers can drive their blood sugar levels too high or too low, putting them at risk for complications. They are faced with new eating and exercise routines, sleepless nights, late parties where alcohol is abundant, and a newfound sense of independence. “During adolescence, there may be a tendency to feel immortal,” says pediatric endocrinologist Ania Jastreboff, MD, PhD , who is also director of the Yale Obesity Research Center (Y-Weight) .

Betancur, who was an undergraduate at Yale, thinks he managed the disease well in college, probably because he doesn’t remember life without it. But there were difficult times. “When you’re sleeping and don’t know your sugar is low, then you wake up, your heart is beating fast and you’re sweating—you think you are dying,” he says. Unlike at home, where his parents would go into his room and check his blood sugar while he was asleep, he was suddenly on his own.

Providers at the Yale Medicine Pediatric Diabetes Program at Yale New Haven Children’s Hospital schedule office visits for college-bound patients in the spring and again in August. Each May, they host a College Day for freshmen, their parents, and older peers like Betancur.

Participants submit questions anonymously: What if a roommate consumes all the snacks put aside in case of a hypoglycemic episode? (They could protect their food with a lock.) What if low blood sugar makes them feel sick during a final exam? (They should be aware of their rights under the American Disabilities Act, which includes the right to reschedule.)

“Our overall mantra is ‘be prepared,’” says Kate Weyman , an APRN and diabetes educator who coordinates College Day. “Know what you’re going to need, know your insulin doses and insulin pump failure plan, carry backup insulin and pump supplies, as well as something to treat low blood sugar at all times. You’re going to be OK, but you have to be prepared and responsible.”

Road map for entering college with diabetes

If young adults like Betancur and their doctors were to provide a road map for college, what would it include?

• Prepare before you go. Visit your doctor in the months prior to school starting (May-August) to discuss a diabetes management plan and get a doctor’s note to take to school. Read up on your rights under the Americans with Disabilities Act and register with the disabilities/auxiliary services office at your school. Find out ahead of time if the college has a chapter of the College Diabetes Network, a nonprofit organization, or some type of peer support group. If you have an opportunity to communicate with roommates, tell them that you have diabetes and explain what that means. Stock up on supplies and backup supplies, and find a pharmacy near campus that you can use. Have medical alert jewelry or a wallet card (some people with diabetes even get medical alert tattoos) so that, if you are in an emergency, people will know you have diabetes. Use the health app on your phone to set up a medical ID, which can be displayed on the phone’s lockscreen and make it possible to make calls to certain numbers identified as contacts in case of emergencies.
• Tell new friends about diabetes. Tell roommates, friends, professors—you want them to know about your disease. They should know that it’s important to get help if they notice problems, like the confusion or even vomiting that can occur if your blood sugar is off track. “I was extremely open about my diabetes in college, often just doing a basic diabetes management task in front of others, which opened the door to conversation,” says Dr. Sherr. “The kids that I worry about most are the ones who feel like diabetes is something they can’t discuss.” While some students are more private, Weyman had a patient who told her, “My parents totally took that over.” The parents told their child’s roommate, “He’s not going to tell you, so we’re going to tell you,” Weyman recounts. “In the end, he was actually grateful they did it. He thought it made them look a little overbearing, but that was OK because it took the focus off of him.”
• Use a pump and a sensor to manage insulin. People with type 1 diabetes can choose how to manage their condition and method of insulin delivery. Dr. Sherr thinks tech-savvy generations will prefer a pump and a sensor system—the latter checks blood sugar levels throughout the day and can send the information to your cell phone, allowing you to track trends, which you can adjust by injecting or pumping insulin. (Yale has participated in clinical trials to study a technology known as the “ artificial pancreas ” that may eventually be used to adjust levels automatically.) “If you can use the sensor to see how walking 20,000 steps in one day leads to a lower glucose number, you know how to change things the next day. But without that information, you are flying a little blind,” Dr. Sherr notes. Betancur says he was reluctant to use a sensor and pump, but it turned out to be Dr. Sherr’s best advice for him. “Everybody is different. But my insulin levels are so much better and my quality of life has improved because of the sensor and pump,” he says.
• Take care of yourself. Diet , exercise , and sleep are extremely important, as are behavioral and mental health, says Elizabeth Doyle, APRN. Doyle has contributed to studies that look at the psychological health of young people with diabetes and says many would benefit from routine psychological screening. This could help caregivers detect more cases of depression and diabetes distress (an emotional state that overlaps with anxiety, depression, and stress). They may be able to detect an eating disorder called diabulimia, where a person with diabetes takes less insulin than is necessary to lose calories through urine. “For those with diabetes,” says Doyle, “it can lead to an acute life-threatening episode of diabetic ketoacidosis and cause their overall diabetes control to get worse.”
• Be cautious about drinking. Alcohol can be a major challenge for college students with diabetes, says Dr. Sherr. Alcohol has carbohydrates, so beer, wine, and hard liquor can drive blood sugar up. Adjusting insulin doses in response can be tricky, because as the liver processes the carbs, blood sugar starts coming back down (especially dangerous if the party is over and you are back in the dorm sleeping). “It’s a very fine balance,” Dr. Sherr says. Doctors suggest planning ahead for situations that involve drinking. “Get good at using technology to watch your trends and learn how to manage them,” Dr. Sherr says, “and make sure someone with you knows you have diabetes.”
• Think about how to talk to family members. A helpful tip is to set a time to talk about diabetes so that it isn’t part of every conversation you have. “You really want to talk about your college experience, not just the diabetes,” Dr. Sherr says. Of course, parents worry, and some parents may be remotely monitoring their child’s blood sugar, having access to all of the potential fluctuations, highs, and lows that may be occurring, Weyman says. “So, it’s good to agree on how you will handle this information before leaving for college. For example, you can agree that if you have high blood sugar, your parents can’t call you right away—they have to wait two hours,” she suggests. “Or the student can text their parents to say, ‘I know. I’ve taken care of it.’” All of this can be difficult when teenagers find themselves in the new world of college after years of meticulous management, Dr. Sherr says. “For a lot of families, I think both the kids and the parents get diabetes burnout. They think this has been going on for too long. I would say families that stay invested—but that aren’t accusatory or judgmental in their tactics—tend to have more success.”

A turning point in diabetes management after graduation

There is light at the end of the tunnel, and it typically arrives at age 25 or 26—certainly by age 28, when insulin levels start leveling out, according to the Type 1 Diabetes Exchange Clinic Registry data.

Weyman, who helps young adults transition to adult care in a Type 1 Diabetes Bridge Transition Clinic, notes, “In my experience, for many patients after college something seems to click, where they realize they feel better if they do the things that help their blood sugar—as opposed to when they eat Lucky Charms and they don’t feel well,” she says.

One of Dr. Jastreboff’s patients is Michelle Slavin, who was diagnosed at age 13 and is now 29 and a nurse practitioner. She was determined not to let the disease hold her back in college. “I checked my blood sugar way more than is common. I’d have glucose tabs in my purse and ask friends to carry glucose tabs as well,” she says.

But toward the end of college, she was grappling with weight gain and subsequent disordered eating patterns, and she was angry—at diabetes.

Her nurse practitioner asked her to pick one thing she’d like to change about her disease. Slavin replied, “I wish I could exercise more.” After further discussion, she and her caregivers worked out a realistic plan that would reduce her hyperglycemia , giving her more freedom to be active. She has since run a half-marathon, a 10-mile race, and several 5Ks, and competes in Brazilian jujitsu.

“I think the most important thing for emerging young adults to know is that diabetes does not define them. That’s a critical point. They get to define who they are as individuals,” Dr. Jastreboff says.

Visit the Yale Medicine Diabetes Content Center for more diabetes-related articles and videos.

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Before matriculation

After arrival at school, other topics to consider, preparing students with diabetes for life at college.

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David C. Mellinger; Preparing Students With Diabetes for Life at College. Diabetes Care 1 September 2003; 26 (9): 2675–2678. https://doi.org/10.2337/diacare.26.9.2675

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Editor’s comment: Although few student health physicians at colleges probably read Diabetes Care , many of our readers care for the type 1 diabetic adolescent who matriculates into college. These practical words of wisdom from a physician who cares for these students during their college tenure should prove helpful while we counsel our young patients for their next (diabetes) challenges.

Each fall, ∼2.3 million freshmen enroll in institutes of higher education in the U.S. ( 1 ). Of these, ∼7,700 will have type 1 diabetes, based on an estimated prevalence rate of 1 of every 300 ( 2 ). As with all chronic illnesses, ongoing issues will certainly arise during the time of their enrollment, so providers need to be able to respond to some of the unique health care and educational needs of students affected by diabetes. This article will provide an overview of some of the situations that students face as they adjust to life at college. To help organize the material, the content that follows is broken down into things to do before matriculation, items to consider once on campus, and some ongoing issues regarding diabetes care while at college.

Ideally, students with diabetes should meet with their primary care provider or endocrinologist before matriculating at an institute of higher education. Such a meeting enables the clinician to review all aspects of the student’s medical care ( 3 ) and to educate the student about some issues that they may not have already considered. Before leaving the prematriculation visit, the student should have a clear understanding of what relationship they will maintain with their home clinician’s office and should ask for copies of their medical records to take with them. Ideally, the student and the clinician should contact the college’s health facility to set up an introductory appointment for the student once they arrive on campus. Direct contact with the student health facility will also provide information regarding the level of service that can be provided so the student’s health care status is optimized.

Before leaving for college, students need to ensure that they have all of the supplies needed to manage their diabetes while at school. Although most remember to take their blood glucose meter, monitoring strips, alcohol wipes, insulin syringes (or pump), and insulin, many will forget items that they can easily find at home (e.g., sharps container) or may not have considered (e.g., urine ketone test strips). Other items to pack include ready sources of glucose (such as small cans of juice and glucose tablets), glucose gel, Medic Alert identification, a copy of important contact phone numbers, and their insurance card. In addition, it is a good idea to assemble a medicine kit for use during times of illness. Such a kit should include a thermometer, nonperishable bland foods and liquids (such as Jell-O, Saltines, broth-based soups, juice, and sugar-free beverages), ketone strips, approved over-the-counter medications (including sugar-free cough drops, etc.), and a copy of their sick-day plan. It is also advisable to have more supplies than anticipated since accidents (such as dropping insulin vials) are not uncommon. Students need to be reminded that their college dormitory will be quite different from their home environment; there may not always be a well-stocked refrigerator or a parent who can quickly go and get needed items.

The monetary costs associated with caring for someone with diabetes are quite large. If a student follows routine published guidelines for the management of their diabetes ( 3 ), the costs each month for diabetes supplies and scheduled health care would total at least $270 ( Table 1 ). Fortunately, many young adults with diabetes have health care insurance, which can substantially reduce its financial impact. But even with health insurance, the out-of-pocket expense can be significant ( 4 ). It is imperative that students review their own health insurance status before enrollment to see how their new status as a college student might have an effect. Many students can continue on their parent’s health insurance policy until 25 years of age, as long as they are enrolled at an institution of higher education. Many policies, however, have a minimum credit hour requirement that must be met in order for the student to continue to have health care coverage. In addition, if the student were to marry, most policies will terminate them from their parents’ policy, necessitating the search for their own insurance coverage.

A second issue that the student may not have faced before is what coverage is provided to them while they are away at school, outside of their local area. This is particularly important for students who are enrolled in health management organizations (HMOs) that may only provide emergency out-of-area coverage. Even if the college health service can provide routine and some emergency care, insurance companies might not cover prescriptions written by college health clinicians who are not considered preferred providers. In these cases, it is best for the student to have a plan for how they will get their supplies and prescriptions while at school, taking into consideration the restrictions that their health insurance provider might place on them. Many pharmacies, particularly national chains, are willing to mail needed prescriptions and supplies anywhere in the U.S. at no charge. If this is not an option, family members might mail the items to the student themselves.

Another issue to consider before going to college is financial aid. It behooves the student to contact local resources and their educational institution to see whether any scholarship money might be available to them. At times, a benefactor may set up a scholarship fund at a college or in a local community for someone with a specific diagnosis such as diabetes. These scholarships may not be advertised and may go unused during the years that no one applies for them. Usually, but not always, such scholarships are for people with demonstrated financial need. Students applying for financial aid should list out-of-pocket expenses for their health care on their application for financial assistance. In cases where students are either uninsured or carry high deductibles, these expenses can be considerable. Finally, in regard to economic assistance, students might qualify for hardship programs run by most pharmaceutical companies. Such programs provide medications and/or supplies free or at greatly reduced cost to people who qualify by earning less than a certain amount each year. These programs are particularly applicable for older returning college students, graduate students, and others who are not financially dependent on their families.

The final critical element for students to review before going to college is their insulin regimen. College students’ lives are often highly unpredictable, and they can have immensely varying daily schedules. On some days, students may need to get up early to attend an 8:00 a.m . class, while on the weekend they may choose to sleep in, waking well after noon. Regular meal times are almost impossible and late-night snacks are usually not planned. Because of the variability from day to day, the insulin plan chosen by each student must allow for a great deal of flexibility. The two regimens which best fit into the college lifestyle are 1 ) the use of a very long–acting insulin (such as ultralente or glargine) ( 5 ) combined with a rapid-onset, short-acting insulin (e.g., lispro) ( 6 ) and 2 ) the use of continuous insulin infusion via an insulin pump. Ideally the student should be on such a regimen for a few months before coming to college so that they are comfortable with adjustments that may need to be made under various circumstances. If a student has excellent glucose control (HbA 1c <7%) on another, less flexible regimen, they may be unmotivated to change their insulin before coming to college. In this circumstance, a discussion about the options should still take place, and the student should be encouraged to consider switching if they discover that maintaining good glucose control on their regimen is difficult once they get to college.

Once at school, one of the first things diabetic college students face is deciding who and what to tell others about their diabetes. At the least, it is highly recommended that they tell their roommate(s) and, if in a residence hall, their hall advisor. The talk should include a discussion about what diabetes is, hopefully dispelling any misconceptions that others might have, and that the student with diabetes plans on participating fully in the college experience. It might be helpful to show the roommate(s) some of the supplies that are used, perhaps even providing the chance for them to test their own blood glucose and/or inject themselves with an empty syringe. As part of the interaction, there should be a discussion about the dangers of hypoglycemia and how to recognize it. The roommate(s) should also be instructed in what to do in case the student with diabetes becomes confused or unarouseable. At the very least, most roommates should be expected to call 911 and administer glucose gel when waiting for the arrival of medical personnel. If the roommate has a significant relationship with the student (e.g., long-time friends), they might be willing to administer glucagon as well. In such a situation, the roommate needs to be trained on how to administer glucagon and should know where it is kept.

As the need arises, the student may wish to tell others about their diabetes. Coaches and fraternities/sororities will probably need to know so as not to jeopardize the student’s health and to assist the student if hypoglycemia occurs. As far as instructional personnel, it is probably only necessary to tell professors if the student needs some accommodation; this would probably be a rare instance.

Because food is an important aspect of diabetes management, it is recommended that the student make an early trip to the cafeteria where he/she plans on eating most of their meals. If not done already, they might ask the food service to post nutritional information, including grams of carbohydrate per serving, next to each entrée that is not already labeled. At a minimum, food service staff should provide the student with access to a document containing this information that they can easily consult. The student should make sure the food selection includes reasonable choices that are compatible with their meal plan. For students who eat out, there are free pamphlets that list all of the entrées available at many of the major fast-food establishments complete with nutritional information to help in meal and insulin planning. Books are also published that contain recipes for students who choose to cook for themselves. As a reminder, students should ensure that they have readily available sources of carbohydrate in their rooms and backpacks for hypoglycemic episodes.

Another federally mandated resource students need to know about is the campus disability center. Protection is afforded to people with diabetes under the Rehabilitation Act and the Americans with Disabilities Act. Although there has been a recent Supreme Court decision that has called into question the Americans with Disabilities Act’s protection of people with diabetes, educational institutions are still required to provide reasonable accommodations for students with this disease. As an example, if a professor refused to allow a make-up examination for a student who had a significant hypoglycemic reaction before or during the scheduled testing time, the campus disability center would get involved to protect the student’s rights. Fortunately, most instructors will not push an issue this far, but the student should at least know how to access the campus disability center if the need arises.

As mentioned previously, early after a student enrolls at college, he/she should make an appointment to see a clinician at the student health service. At this meeting, there should be time to review all aspects of the student’s diabetes management and to educate them about the role the college health facility can play in their diabetes care. Other issues to cover include the following. 1 ) What services are available to the student and the cost (if any) of these (e.g., laboratory tests such as quarterly HbA 1c tests ( 7 ), routine sick care, dietitian visits, etc.). 2 ) How to communicate with the health service about health care issues (e.g., email, phone, and letters) and the type of messages that are best handled by each method of communication. 3 ) The location of pharmacies in town (including 24-h pharmacies, if available). 4 ) Where night, weekend, and emergency services are available and how to access them. 5 ) Information about any support groups found on campus or in the area.

Exercise is another important aspect in the management of diabetes and should be strongly encouraged for all patients in whom there are no medical contraindications ( 8 , 9 ). Aside from its beneficial effect on glycemic control, exercise also impacts favorably on other known risk factors for cardiovascular disease that patients with diabetes often have as comorbidities, including lipid abnormalities and hypertension ( 10 ). Exercise can also boost self-esteem and improve a student’s body image, factors that may be more motivating to college students than any of the previously listed benefits. Practical advice to share with students who engage in exercise includes always having a ready source of glucose available, the importance of adequate hydration, and the need to monitor for hypoglycemia during and after exercise. Concrete guidelines to share with patients with diabetes include the need to avoid exercise if their blood glucose is >250 mg/dl and ketosis is present or if their blood glucose is >300 mg/dl, regardless of whether they are ketotic. In addition, the patient should also consider ingesting carbohydrates if their preexercise glucose level is <100 mg/dl ( 11 ).

Because of the ubiquitous presence of alcohol in the lives of college students, a frank conversation about its safe use should be had with all students with diabetes, even those who state that they currently don’t drink ( 12 , 13 , 14 ). In addition to the negative impact that high-risk drinking has on all college students, people with diabetes have additional concerns associated with alcohol use. Although alcohol can worsen or increase the risk of known diabetes complications (including neuropathy, retinopathy [ 15 ], gastrointestinal dysfunction, lipid abnormalities, and impotence), its most immediate impact is related to its effects on glucose metabolism ( 16 ). The most dangerous potential complication is that of alcohol-related hypoglycemia, both as a direct and indirect consequence of drinking ( 17 ). Alcohol-induced hypoglycemia occurs mainly in patients in the fasted state and is related to alcohol’s ability to block gluconeogenesis, thus limiting one of the body’s responses to a low blood glucose level. Indirectly, alcohol can impair judgment and cause people to forget to monitor their blood glucose or even eat. Some people with diabetes can also have diminished hypoglycemic awareness as a result of alcohol’s effects on the central nervous system ( 18 ), which is another factor that can lead to significant consequences associated with a lack of appropriate response to a low blood glucose level. One can imagine a scenario in which a diabetic student’s friends feel he/she is intoxicated when in fact that student is displaying the effects of hypoglycemia. If no help is provided, the hypoglycemic student could progress to seizure, coma, or even death. For these reasons, advice about the safe use of alcohol should be shared with all diabetic patients. Practical suggestions regarding safer alcohol consumption include: 1 ) limiting alcohol use to 2–3 drinks per day, 2 ) not drinking on an empty stomach, 3 ) drinking with someone who recognizes and knows how to treat hypoglycemia, and 4 ) only drinking when in good metabolic control. One final alcohol-related item for diabetic patients concerns not taking into account the grams of carbohydrate contained in beer and the mixers used in combination with distilled spirits. Having the patient add up the carbohydrate and calorie count of an evening out may be an eye-opening exercise.

Sexual health is another topic that should be covered during an initial meeting with college students with diabetes. Aside from the effects that sexual activity can have on blood glucose levels (many report a decrease of blood glucose with intercourse), students should be educated about other factors in regard to diabetes and sexual health. Male students may have concerns about impotence, either because it is affecting them already or they are worried about the possibility of it in the future. A candid discussion about erectile dysfunction and options for management may provide the student with important information and might serve as a motivator for better blood glucose management. Women should be counseled about effective contraception and the need for excellent glucose control before conception to help prevent pregnancy loss and congenital malformations ( 19 ). The idea that pregnancy should be a planned event should be stressed. For women wanting to have children, this knowledge may serve as a motivating factor for tight glucose control and contraception use if sexually active.

Anticipatory guidance about sick-day management is another topic to discuss in an initial visit with students with diabetes ( 20 ). Each student should have a sick-day plan, including guidelines for adjusting insulin, the need for additional monitoring of blood glucose levels and ketones, and the need for adequate hydration when they are ill. Giving specific written instructions about when to call the doctor is often helpful because the student may not have had to think about this when they were still living at home. Guidelines for when to call include incessant vomiting or diarrhea, a temperature that remains above 101°F, moderate or large ketones in the urine, or blood glucose level of <60 mg/dl or one that persistently stays >240 mg/dl. In addition, as previously mentioned, the student should have a sick-day kit with supplies that may be useful on days when they are ill. Finally, in regard to illness prevention, the clinician should remind the student with diabetes that it is recommended that they get a yearly influenza vaccine. A reminder before the yearly vaccine campaign may increase compliance with this highly effective prevention measure.

In conclusion, this article should serve as a starting point for providers who care for students with diabetes. With support, students with diabetes should be able to effectively make the transition to life at college and continue to have success throughout their college careers.

Monthly expenses for diabetes care *

Prices from UHS Pharmacy, Madison, Wisconsin, as of 2003;

1/12 of cost of annual ophthalmology visit.

A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

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Facing Adversity: A Personal Experience of Overcoming the Difficulties of Type 1 Diabetes

My life changed suddenly on my first day of third grade. I was lying on a hospital bed when a doctor said, “I am sorry, you have type 1 diabetes.” At the time, I did not understand what diabetes was and how it would affect my future. All I knew was that my life would never be the same. My parents were worried that I would not be able to do things that other kids did, but as it turned out, maturing at a young age and taking on responsibilities made me who I am today. My first reaction when I heard the news was to ask; “Will I ever be able to eat doughnuts again?” I had a feeling my life as I knew it was going to change. Fast food and desserts were hastily eliminated from my diet. During Girl Scout meetings and birthday parties, I had to turn down the sugary menu. Eventually, my new healthy diet helped manage my blood sugar levels and taught me an important lesson: feeling well starts with eating well. I also had to learn to listen to my body. At first, I did not recognize the symptoms of hypoglycemia and hyperglycemia. I slowly started to match the dizzy, shaky feeling with low blood sugars and the nauseous moody feeling with high blood sugars. With this knowledge in mind, I was able to take the measures to correct the low or high blood sugar levels before they became dangerous. I learned to listen to my instincts. Over time, I also learned the importance of being patient with others who may not understand diabetes. In elementary school, my classmates would ask me questions like “Can you not eat sugar ever again?” and “What is that?” as they point to my insulin pump. I knew that others did not understand what it is like to be in my shoes, so I always answered their questions sincerely and with patience. Sometimes, it was hard being the only child at school who had diabetes. Even though I had my family and many friends who supported me, I felt alone. My condition was new to me and I had no diabetic role models to show me the way. I had to learn about diabetes through experience. I knew others were striving to understand my diabetes too, but they could never know how it feels to have huge responsibilities that directly affect their health. The major lifestyle change from my diagnosis was my new responsibilities and independence. I had to learn early on how to take care of my blood sugar levels without my parents' help since I was alone at school. My parents encouraged me to learn how to give myself insulin shots and check my blood sugar. After about a year, I could perform those tasks and manage my diabetes on my own. This trust made me responsible since I knew I had to make the best decisions for myself. My control over my diabetes showed my parents that I could be trusted with even bigger responsibilities down the road such as driving and deciding what career I should pursue. I also learned how to handle responsibilities as life gave them to me, such as homework and preparing for the ACT. Being diagnosed with diabetes taught me the importance of consequences. If I do not check my blood sugars and control my diabetes, I run the risk of putting myself in a medical emergency. In the same way, if I do not keep up with my homework and prepare for tests, my grades will suffer. The moment I was diagnosed with diabetes was the beginning of a new me. At first, I did not think I could make the lifestyle changes I did in order to be healthy, but I did and I faced it with courage.

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Quality of Life of College Students Living With Type 1 Diabetes: A Qualitative View

Affiliations.

• 1 Mount Wachusett Community College, Gardner, MA, USA [email protected].
• 2 University of Massachusetts Lowell, Lowell, MA, USA.
• 3 Stanford University School of Medicine, Stanford, CA, USA.
• 4 UMass Memorial Medical Center, Worcester, MA, USA.
• PMID: 27230752
• DOI: 10.1177/0193945916651265

The purpose of this phenomenological qualitative study was to examine the quality of life among college students living with Type 1 diabetes (T1D). Inclusion criteria included age 18 to 24, current college student, and a diagnosis of T1D for at least 1 year. Semi-structured interviews were conducted, in-person and by phone. During these interviews, college students shared stories of living with T1D and its impact on their quality of life. Three major themes emerged, which included "planning ahead," "thinking positive," and "seeking support." These findings provide a better understanding of the transitional experience of living with T1D and the impact on perceived quality of life while attending college. Techniques and strategies aimed at the enhancement of perceived quality of life for college students living with T1D were identified. These findings will provide valuable insight for professionals working with this population.

Keywords: College Diabetes Network; Type 1 diabetes; college students; emerging adults; phenomenology; qualitative research.

© The Author(s) 2016.

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357 Diabetes Essay Topics & Examples

When you write about the science behind nutrition, heart diseases, and alternative medicine, checking titles for diabetes research papers can be quite beneficial. Below, our experts have gathered original ideas and examples for the task.

🏆 Best Diabetes Essay Examples & Topics

⭐ most interesting diabetes research paper topics, ✅ simple & easy diabetes essay topics, 🎓 good research topics about diabetes, 💡 interesting topics to write about diabetes, 👍 good essay topics on diabetes, ❓ diabetes research question examples.

• Type 2 Diabetes The two major types of diabetes are type 1 diabetes and type 2 diabetes. Doctor: The first step in the treatment of type 2 diabetes is consumption of healthy diet.
• Living With a Chronic Disease: Diabetes and Asthma This paper will look at the main effects of chronic diseases in the lifestyle of the individuals and analyze the causes and the preventive measures of diabetes as a chronic disease.
• Leadership in Diabetes Management Nurses can collaborate and apply evidence-based strategies to empower their diabetic patients. The involvement of all key stakeholders is also necessary.
• Relation Between Diabetes And Nutrition Any efforts to lessen and eliminate the risk of developing diabetes must involve the dietary habit of limiting the consumption of carbohydrates, sugar, and fats. According to Belfort-DeAguiar and Dongju, the three factors of obesity, […]
• Diabetes Mellitus: Symptoms, Types, Effects Insulin is the hormone that controls the levels of glucose in the blood, and when the pancreas releases it, immediately the high levels are controlled, like after a meal.
• Diabetes Issues: Insulin Price and Unaffordability According to the forecast of researchers from Stanford University, the number of people with type 2 diabetes who need insulin-containing drugs in the world will increase by about 79 million people by 2030, which will […]
• Diabetes Mellitus Management in the Elderly Diabetes mellitus is a health complication involving an increase in the concentration in the concentration of blood sugar either due to a failure by cells to effectively respond to the production of insulin in the […]
• Type 2 Diabetes as a Public Health Issue In recent years, a steady increase in the incidence and prevalence of diabetes is observed in almost all countries of the world.
• Diabetes Self-Management: Evidence-Based Nursing The article by Seley and Weinger, improving diabetes self management attempts to address the possible barriers to patient education and the role of the nurse in assisting the patient to manage diabetes.
• Diabetes Mellitus Type 2: Pathophysiology and Treatment The primary etiologies linked to the patient’s T2DM condition include morbid obesity and family history. The genetic factors implicated in T2DM pathogenesis relate to a family history of the disease.
• The Aboriginal Diabetes Initiative in Canada The ADI’s goal in the CDS was to raise type 2 diabetes awareness and lower the incidence of associated consequences among Aboriginal people.
• Case Study of Patient with DKA and Diabetes Mellitus It is manifested by a sharp increase in glucose levels and the concentration of ketone bodies in the blood, their appearance in the urine, regardless of the degree of violation of the patient’s consciousness.
• Diabetes and Its Economic Effect on Healthcare For many years, there has been an active increase in the number of cases of diabetes of all types among the global population, which further aggravates the situation.
• Nursing Care For the Patient With Diabetes The right diagnosis of a patient’s condition also helps in the administering of the right medication. In this case, the doctor would keep the goal of administering the right medication to the patient.
• The Minority Diabetes Initiative Act’s Analysis The bill provides the right to the Department of Health and Human Services to generate grants to public and nonprofit private health care institutions with the aim of providing treatment for diabetes in minority communities.
• Diabetes Patients’ Long-Term Care and Life Quality Since insulin resistance can be lowered through weight reduction which, in turn, decreases the severity of the condition, it is also often incorporated into the long-term care of patients with Type 2 diabetes.
• Gestational Diabetes in a 38-Year-Old Woman The concept map, created to meet B.’s needs, considers her educational requirements and cultural and racial hurdles to recognize her risk factors and interventions to increase her adherence to the recommended course of treatment.B.said in […]
• Type 2 Diabetes Mellitus and Its Implications You call an ambulance and she is taken in to the ED. Background: Jean is still very active and works on the farm 3 days a week.
• Development of Comprehensive Inpatient and Outpatient Programs for Diabetes Overcoming the fiscal and resource utilization issues in the development of a comprehensive diabetes program is essential for the improvement of health and the reduction of treatment costs.
• Healthcare Cost Depending on Chronic Disease Management of Diabetes and Hypertension A sufficient level of process optimization and the presence of a professional treating staff in the necessary number will be able to help improve the indicators.
• Improving Glycemic Control in Black Patients with Type 2 Diabetes Information in them is critical for answering the question and supporting them with the data that might help to acquire an enhanced understanding of the issue under research. Finally, answering the PICOT question, it is […]
• Shared Decision-Making That Affects the Management of Diabetes The article by Peek et al.is a qualitative study investigating the phenomenon of shared decision-making that affects the management of diabetes. The researchers demonstrate the racial disparity that can arise in the choice of approaches […]
• Managing Obesity as a Strategy for Addressing Type 2 Diabetes When a patient, as in the case of Amanda, requires a quick solution to the existing problem, it is necessary to effectively evaluate all options in the shortest possible time.
• Tests and Screenings: Diabetes and Chronic Kidney Disease The test is offered to patients regardless of gender, while the age category is usually above 45 years. CDC1 recommends doing the test regardless of gender and is conducted once or twice to check the […]
• Obesity Management for the Treatment of Type 2 Diabetes American Diabetes Association states that for overweight and obese individuals with type 2 diabetes who are ready to lose weight, a 5% weight reduction diet, physical exercise, and behavioral counseling should be provided.
• COVID-19 and Diabetes Mellitus Lim et al, in their article, “COVID-19 and diabetes mellitus: from pathophysiology to clinical management”, explored how COVID-19 can worsen the symptoms of diabetes mellitus.
• The Importance of Physical Exercise in Diabetes II Patients The various activities help to improve blood sugar levels, reduce cardiovascular cases and promote the overall immunity of the patient. Subsequently, the aerobic part will help to promote muscle development and strengthen the bones.
• Diabetes Education Workflow Process Mapping DSN also introduces the patient to the roles of specialists involved in managing the condition, describes the patient’s actions, and offers the necessary educational materials.
• Diabetes: Treatment Complications and Adjustments One of the doctor’s main priorities is to check the compatibility of a patient’s medications. The prescriptions of other doctors need to be thoroughly checked and, if necessary, replaced with more appropriate medication.
• The Type 2 Diabetes Mellitus PICOT (Evidence-Based) Project Blood glucose levels, A1C, weight, and stress management are the parameters to indicate the adequacy of physical exercise in managing T2DM.
• Chronic Disease Cost Calculator (Diabetes) This paper aims at a thorough, detailed, and exhaustive explanation of such a chronic disease as diabetes in terms of the prevalence and cost of treatment in the United States and Maryland.
• Diabetes Mellitus Epidemiology Statistics This study entails a standard established observation order from the established starting time to an endpoint, in this case, the onset of disease, death, or the study’s end. It is crucial to state this value […]
• Epidemiology: Type II Diabetes in Hispanic Americans The prevalence of type II diabetes in Hispanic Americans is well-established, and the search for inexpensive prevention methods is in the limelight.
• Diabetes: Risk Factors and Effects Trends in improved medical care and the development of technology and medicine are certainly contributing to the reduction of the problem. All of the above indicates the seriousness of the problem of diabetes and insufficient […]
• Barriers to Engagement in Collaborative Care Treatment of Uncontrolled Diabetes The primary role of physicians, nurses, and other healthcare team members is to provide patients with medical treatment and coordinate that care while also working to keep costs down and expand access.
• Hereditary Diabetes Prevention With Lifestyle Modification Yeast infections between the fingers and toes, beneath the breast, and in or around the genital organs are the common symptoms of type 2 diabetes.
• Health Equity Regarding Type 2 Diabetes According to Tajkarimi, the number of research reports focusing on T2D’s prevalence and characteristics in underserved minorities in the U. Adapting the program’s toolkits to rural Americans’ eating and self-management habits could also be instrumental […]
• Diabetes Mellitus: Treatment Methods Moreover, according to the multiple findings conducted by Park et al, Billeter et al, and Tsilingiris et al, bariatric surgeries have a positive rate of sending diabetes into remission.
• Diagnosing Patient with Insulin-Dependent Diabetes The possible outcomes of the issues that can be achieved are discussing the violations with the patient’s family and convincing them to follow the medical regulations; convincing the girl’s family to leave her at the […]
• Human Service for Diabetes in Late Adulthood The mission of the Georgia Diabetic Foot Care Program is to make a positive difference in the health of persons living with diabetes.
• Diabetes: Symptoms and Risk Factors In terms of the problem, according to estimates, 415 million individuals worldwide had diabetes mellitus in 2015, and it is expected to rise to 642 million by the year 2040.
• Diabetes: Types and Management Diabetes is one of the most prevalent diseases in the United States caused when the body fails to optimally metabolize food into energy.
• Type 2 Diabetes’ Impact on Australian Society Consequently, the most significant impact of the disease is the increased number of deaths among the population which puts their lives in jeopardy. Further, other opportunistic diseases are on the rise lowering the quality of […]
• Epidemiology of Diabetes and Forecasted Trends The authors note that urbanization and the rapid development of economies of different countries are the main causes of diabetes. The authors warn that current diabetes strategies are not effective since the rate of the […]
• Communicating the Issue of Diabetes The example with a CGM sensor is meant to show that doctors should focus on educating people with diabetes on how to manage their condition and what to do in extreme situations.
• Obesity and Diabetes Mellitus Type 2 The goal is to define the features of patient information to provide data on the general course of the illness and its manifestations following the criteria of age, sex, BMI, and experimental data.
• The Prevention of Diabetes and Its Consequences on the Population At the same time, these findings can also be included in educational programs for people living with diabetes to warn them of the risks of fractures and prevent them.
• Uncontrolled Type 2 Diabetes and Depression Treatment The data synthesis demonstrates that carefully chosen depression and anxiety treatment is likely to result in better A1C outcomes for the patient on the condition that the treatment is regular and convenient for the patients.
• Type 2 Diabetes: Prevention and Education Schillinger et al.came to the same conclusion; thus, their findings on the study of the Bigger Picture campaign effectiveness among youth of color are necessary to explore diabetes prevention.
• A Diabetes Quantitative Article Analysis The article “Correlates of accelerometer-assessed physical activity and sedentary time among adults with type 2 diabetes” by Mathe et al.refers to the global issue of the prevention of diabetes and its complications.
• A Type 2 Diabetes Quantitative Article Critique Therefore, the main issue is the prevention of type 2 diabetes and its consequences, and this paper will examine one of the scientific studies that will be used for its exploration.
• The Diabetes Prevention Articles by Ford and Mathe The main goal of the researchers was to measure the baseline MVPA of participants and increase their activity to the recommended 150 minutes per week through their participation in the Diabetes Community Lifestyle Improvement Program.
• Type 2 Diabetes in Hispanic Americans The HP2020 objectives and the “who, where, and when” of the problem highlight the significance of developing new, focused, culturally sensitive T2D prevention programs for Hispanic Americans.
• Diabetes Mellitus as Problem in US Healthcare Simultaneously, insurance companies are interested in decreasing the incidence of diabetes to reduce the costs of testing, treatment, and provision of medicines.
• Diabetes Prevention as a Change Project All of these queries are relevant and demonstrate the importance of including people at high risk of acquiring diabetes in the intervention.
• Evidence Synthesis Assignment: Prevention of Diabetes and Its Complications The purpose of this research is to analyze and synthesize evidence of good quality from three quantitative research and three non-research sources to present the problem of diabetes and justify the intervention to address it.
• Diabetes Mellitus: Causes and Health Challenges Second, the nature of this problem is a clear indication of other medical concerns in this country, such as poor health objectives and strategies and absence of resources.
• Diabetes in Adults in Oxfordshire On a national level, Diabetes Research and Wellness Foundation aims to prevent the spread of the decease through research of the causes and effective treatment of diabetes 2 type.
• Diabetes Mellitus (DM) Disorder Case Study Analysis Thus, informing the patient about the importance of regular medication intake, physical activity, and adherence to diet in maintaining diabetes can solve the problem.
• Diabetes Mellitus in Young Adults Thus, programs for young adults should predominantly focus on the features of the transition from adolescence to adulthood. As a consequence, educational programs on diabetes improve the physical and psychological health of young adults.
• A Healthcare Issue of Diabetes Mellitus Diabetes mellitus is seen as a primary healthcare issue that affects populations across the globe and necessitates the combination of a healthy lifestyle and medication to improve the quality of life of people who suffer […]
• Control of LDL Cholesterol Levels in Patients, Gestational Diabetes Mellitus In addition, some patients with hypercholesterolemia may have statin intolerance, which reduces adherence to therapy, limits treatment efficacy, and increases the risk of CVD.
• Exploring Glucose Tolerance and Gestational Diabetes Mellitus In the case of a glucose tolerance test for the purpose of diagnosing GDM type, the interpretation of the test results is carried out according to the norms for the overall population.
• Type 2 Diabetes Health Issue and Exercise This approach will motivate the patient to engage in exercise and achieve better results while reducing the risk of diabetes-related complications.
• Diabetes Interventions in Children The study aims to answer the PICOT Question: In children with obesity, how does the use of m-Health applications for controlling their dieting choices compare to the supervision of their parents affect children’s understanding of […]
• Diabetes Tracker Device and Its Advantages The proposed diabetes tracker is a device that combines the functionality of an electronic BGL tester and a personal assistant to help patients stick to their diet plan.
• Disease Management for Diabetes Mellitus The selection of the appropriate philosophical and theoretical basis for the lesson is essential as it allows for the use of an evidence-based method for learning about a particular disease.
• Latino People and Type 2 Diabetes The primary aim of the study is to determine the facilitators and barriers to investigating the decision-making process in the Latin population and their values associated with type 2 diabetes.
• Diabetes Self-Management Education and Support Program The choice of this topic and question is based on the fact that despite the high prevalence of diabetes among adolescents in the United States, the use of DSMES among DM patients is relatively low, […]
• Diabetes Mellitus Care Coordination The aim is to establish what medical technologies, care coordination and community resources, and standards of nursing practice contribute to the quality of care and safety of patients with diabetes.
• Healthy Lifestyle Interventions in Comorbid Asthma and Diabetes In most research, the weight loss in cases of comorbid asthma and obesity is reached through a combination of dietary interventions and physical exercise programs.
• PDSA in Diabetes Prevention The second step in the “Do” phase would be to isolate a few members of the community who are affected by diabetes voluntarily.
• Diabetes: Statistics, Disparities, Therapies The inability to produce adequate insulin or the body’s resistance to the hormone is the primary cause of diabetes. Diabetes is a serious health condition in the U.S.and the world.
• Type 2 Diabetes Prescriptions and Interventions The disadvantage is the difficulty of obtaining a universal model due to the complexity of many factors that can affect the implementation of recommendations: from the variety of demographic data to the patient’s medical history.
• Health Education for Female African Americans With Diabetes In order to address and inform the public about the challenges, nurses are required to intervene by educating the population on the issues to enhance their understanding of the risks associated with the conditions they […]
• Diabetes Risk Assessment and Prevention It is one of the factors predisposing patients suffering from diabetes to various cardiovascular diseases. With diabetes, it is important to learn how to determine the presence of carbohydrates in foods.
• Diabetes Mellitus: Preventive Measures In addition to addressing the medical specialists who will be of service in disease prevention, it will emphasize the intervention programs required to help control the spread of the illness.
• “The Diabetes Online Community” by Litchman et al. The researchers applied the method of telephone interviews to determine the results and effectiveness of the program. The study described the value of DOC in providing support and knowledge to older diabetes patients.
• Mobile App for Improved Self-Management of Type 2 Diabetes The central focus of the study was to assess the effectiveness of the BlueStar app in controlling glucose levels among the participants.
• Type 2 Diabetes in Minorities from Cultural Perspective The purpose of this paper is to examine the ethical and cultural perspectives on the issue of T2DM in minorities. Level 2: What are the ethical obstacles to treating T2DM in ethnic and cultural minorities?
• Ethics of Type 2 Diabetes Prevalence in Minorities The purpose of this article analysis is to dwell on scholarly evidence that raises the question of ethical and cultural aspects of T2DM prevalence in minorities.
• Type 2 Diabetes in Minorities: Research Questions The Level 2 research questions are: What are the pathophysiological implications of T2DM in minorities? What are the statistical implications of T2DM in minorities?
• Improving Adherence to Diabetes Treatment in Primary Care Settings Additionally, the patients from the intervention group will receive a detailed explanation of the negative consequences of low adherence to diabetes treatment.
• An Advocacy Tool for Diabetes Care in the US To ensure the implementation and consideration of my plea, I sent a copy of the letter to the government officials so it could reach the president.
• Diabetes and Allergies: A Statistical Check The current dataset allowed us to test the OR for the relationship between family history of diabetes and the presence of diabetes in a particular patient: all variables were dichotomous and discrete and could take […]
• Type 2 Diabetes in Adolescents According to a National Diabetes Statistics Report released by the Centers for Disease Control and Prevention, the estimated prevalence of the disease was 25 cases per 10,000 adolescents in 2017. A proper understanding of T2D […]
• Analysis of Diabetes and Its Huge Effects In the US, diabetes is costly to treat and has caused much physical, emotional and mental harm to the people and the families of those who have been affected by the disease.
• Nursing: Self-Management of Type II Diabetes Sandra Fernandes and Shobha Naidu’s journal illustrates the authors’ understanding of a significant topic in the nursing profession.”Promoting Participation in self-care management among patients with diabetes mellitus” article exposes readers to Peplau’s theory to understand […]
• The Impact of Vegan and Vegetarian Diets on Diabetes Vegetarian diets are popular for a variety of reasons; according to the National Health Interview Survey in the United States, about 2% of the population reported following a vegetarian dietary pattern for health reasons in […]
• “Diabetes Prevention in U.S. Hispanic Adults” by McCurley et al. This information allows for supposing that face-to-face interventions can be suitable to my practicum project that considers measures to improve access to care among African Americans with heart failure diseases. Finally, it is possible to […]
• Diabetes Disease of the First and Second Types It is a decrease in the biological response of cells to one or more effects of insulin at its average concentration in the blood. During the first type of diabetes, insulin Degludec is required together […]
• The Trend of the Higher Prevalence of Diabetes According to the CDC, while new cases of diabetes have steadily decreased over the decades, the prevalence of the disease among people aged below twenty has not.
• Person-Centered Strategy of Diabetes and Dementia Care The population of focus for this study will be Afro-American women aged between sixty and ninety who have diabetes of the second type and dementia or are likely to develop dementia in the future.
• Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services For example, during one of my interactions with the patient, I was asked whether the hospital had the policy to avoid face-to-face interaction during the pandemic with the help of video examinations.
• Diets to Prevent Heart Disease, Cancer, and Diabetes In order to prevent heart disease, cancer, and diabetes, people are required to adhere to strict routines, including in terms of diet. Additionally, people wanting to prevent heart disease, cancer, and diabetes also need to […]
• The Centers for Diabetes’ Risks Assessment In general, the business case for the Centers for Diabetes appears to be positive since the project is closely aligned with the needs of the community and the targets set by the Affordable Care Act.
• Diabetes Management: Case Study Type 1 and Type 2 diabetes contrast based on their definitions, the causes, and the management of the conditions. Since the CDC promotes the avoidance of saturated fat and the increase of fiber intake for […]
• Intervention Methods for Type 2 Diabetes Mellitus An individual should maintain a regulated glycemic control using the tenets of self-management to reduce the possibility of complications related to diabetes.
• Diabetes Mellitus as Leading Cause of Disability The researchers used data from the Centers for Disease Control and Prevention, where more than 12% of older people in the US live with the condition.
• Depression in Diabetes Patients The presence of depression concomitant to diabetes mellitus prevents the adaptation of the patient and negatively affects the course of the underlying disease.
• The Relationship Between Diabetes and COVID-19 After completing the research and analyzing the articles, it is possible to suggest a best practice that may be helpful and effective in defining the relationship between diabetes and COVID-19 and providing a way to […]
• Pre-diabetes and Urinary Incontinence Most recent reports indicate that a physiotherapy procedure gives a positive result in up to 80% of patients with stage I or SUI and mixed form and 50% of patients with stage II SUI.
• Type 1 Diabetes: Recommendations for Alternative Drug Treatments Then, they have to assess the existing levels of literacy and numeracy a patient has. Tailoring educational initiatives to a person’s unique ethnic and cultural background is the basis of cultural competence in patient education.
• Type 2 Diabetes: A Pharmacologic Update Diabetes presents one of the most common diagnoses in causes of ED visits among adults and one of the leading causes of death in the United States.
• Type 2 Diabetes and Its Treatment The main difference in type 2 diabetes is the insensitivity of the body’s cells to the action of the hormone insulin and their insulin resistance.
• Diabetes: Vulnerability, Resilience, and Care In nursing care, resilience is a critical concept that shows the possibility of a person to continue functioning and meeting objectives despite the existing challenges.
• Diabetes Prevention in the United States The analysis of these policies and the other strategies provides the opportunity to understand what role they might play in the improvement of human health. NDPP policy, on the other hand, emphasizes the role of […]
• Teaching Experience: Diabetes Prevention The primary objective of the seminar is to reduce the annual number of diabetes cases and familiarize the audience with the very first signs of this disease.
• Summary of Type 2 Diabetes: A Pharmacologic Update The authors first emphasize that T2D is one of the most widespread diseases in the United States and the seventh leading cause of death.
• Insulin Effects in a Diabetes Person I will use this source to support my research because the perception of diabetes patients on insulin therapy is essential for understanding the impact they cause on the person.
• Diabetes and Medical Intervention In the research conducted by Moin et al, the authors attempted to define the scope of efficiency of such a tool as an online diabetes prevention program in the prevention of diabetes among obese/overweight population […]
• Diabetes Mellitus Type 2 and a Healthy Lifestyle Relationship The advantage of this study over the first is that the method uses a medical approach to determining the level of fasting glucose, while the dependences in the study of Ugandans were found using a […]
• Diabetes: Epidemiological Analysis I would like to pose the following question: how can epidemiology principles be applied to these statistics for further improvements of policies that aim to reduce the impact of diabetes on the U.S.population? The limited […]
• Pathogenesis and Prevention of Diabetes Mellitus and Hypertension The hormone is produced by the cells of the islets of Langerhans found in the pancreas. It is attributed to the variation in the lifestyle of these individuals in these two geographical zones.
• Parental Intervention on Self-Management of an Adolescent With Diabetes Diabetes development and exposure are strongly tied to lifestyle, and the increasing incidents rate emphasizes the severity of the population’s health problem.
• Addressing the Needs of Hispanic Patients With Diabetes Similarly, in the program at hand, the needs of Hispanic patients with diabetes will be considered through the prism of the key specifics of the community, as well as the cultural background of the patients.
• Diabetes: Epidemiologic Study Design For instance, the range of their parents’ involvement in the self-management practices can be a crucial factor in treatment and control.
• What to Know About Diabetes? Type 1 diabetes is caused by autoimmune reaction that prevent realization of insulin in a body. Estimated 5-10% of people who have diabetes have type 1.
• Diabetes in Saudi Arabia It is expected that should this underlying factor be discovered, whether it is cultural, societal, or genetic in nature, this should help policymakers within Saudi Arabia create new governmental initiatives to address the problem of […]
• “Medical Nutrition Therapy: A Key to Diabetes Management and Prevention” Article Analysis In the process of MNT application, the dietitian keeps a record of the changes in the main components of food and other components of the blood such as blood sugars to determine the trend to […]
• Nutrition and Physical Activity for Children With a Diabetes When a child understands that the family supports him or her, this is a great way to bring enthusiasm in dealing with the disease.
• Global and Societal Implications of the Diabetes Epidemic The main aim of the authors of this article seems to be alerting the reader on the consequences of diabetes to the society and to the whole world.
• Diabetes and Hypertension Avoiding Recommendations Thus, the promotion of a healthy lifestyle should entail the encouragement of the population to cease smoking and monitor for cholesterol levels.
• Pregnant Women With Type I Diabetes: COVID-19 Disease Management The grounded theory was selected for the given topic, and there are benefits and drawbacks of utilizing it to study the experiences of pregnant women with type I diabetes and COVID-19.
• Current Recommendations for the Glycemic Control in Diabetes Management of blood glucose is one of the critical issues in the care of people with diabetes. Therefore, the interval of the A1C testing should also depend on the condition of the patient, the physician’s […]
• Diabetes Mellitus: Types, Causes, Presentation, Treatment, and Examination Diabetes mellitus is a chronic endocrinologic disease, which is characterized by increased blood glucose concentration.
• Diabetes Problem at Country Walk Community: Intervention and Evaluation This presentation develops a community health nursing intervention and evaluation tool for the diabetes problem affecting Country Walk community.
• Communication Challenges Between Nurses and Patients With Type 2 Diabetes According to Pung and Goh, one of the limitations of communication in a multicultural environment is the language barrier that manifests itself in the direct interaction of nurses with patients and in the engagement work […]
• Diabetes Type 2 from Management Viewpoint Demonstrate the effects of type 2 diabetes and provide background information on the disease; Discuss the management plans of diabetes centers and critically analyze the frameworks implemented in the hospitals; Examine the existing methodology models […]
• Nursing Plan for the Patient with Diabetes Type 2, HTN, and CAD The health of the population is the most valuable achievement of society, so the preservation and strengthening of it is an essential task in which everyone should participate without exception.
• Diagnosis and Classification of Diabetes Mellitus Diabetes is a serious public health concern that introduces a group of metabolic disorders caused by changes in the sugar blood level.
• Diabetes Mellitus Type II: A Case of a Female Adult Patient In this presentation, we are going to develop a care plan for a 47-year-old woman with a 3-year-old history of Diabetes Mellitus Type 2 (also known as Type II DM).
• Diabetes Insipidus: Disease Process With Implications for Healthcare Professionals This presentation will consider the topic of Diabetes Insipidus (DI) with a focus on its etiology and progress.
• The Nature of Type 1 Diabetes Mellitus Type 1 diabetes mellitus is a chronic autoimmune disease that has an active genetic component, which is identified by increased blood glucose levels, also known as hyperglycemia.
• A Study of Juvenile Type 1 Diabetes in the Northwest of England The total number of children under seventeen years living with type 1 diabetes in North West England by 2009 was 2,630.
• Imperial Diabetes Center Field Study The purpose is to examine the leadership’s practices used to maintain and improve the quality and safety standards of the facility and, using the observations and scholarly research, offer recommendations for improvement.
• Diabetes Risk Assessment After completing the questionnaire, I learned that my risk for the development of diabetes is above average. Modern risk assessment tools allow identifying the current state of health and possibilities of developing the disease.
• The Role of Telenursing in the Management of Diabetes Type 1 Telemedicine is the solution that could potentially increase the coverage and improve the situation for many t1DM patients in the world.
• Health Issues of Heart Failure and Pediatric Diabetes As for the population, which is intended to participate in the research, I am convinced that there is the need to specify the patients who should be examined and monitored.
• Juvenile Diabetes: Demographics, Statistics and Risk Factors Juvenile diabetes, also referred to as Type 2 diabetes or insulin-dependent diabetes, describes a health condition associated with the pancreas’s limited insulin production. The condition is characterized by the destruction of the cells that make […]
• Diabetes Mellitus: Pathophysiologic Processes The main function of insulin produced by cells within the pancreas in response to food intake is to lower blood sugar levels by the facilitation of glucose uptake in the cells of the liver, fat, […]
• Type 2 Diabetes Management in Gulf Countries One such study is the systematic review on the quality of type 2 diabetes management in the countries of the cooperation council for the Arab states of the Gulf, prepared by Alhyas, McKay, Balasanthiran, and […]
• Patient with Ataxia and Diabetes Mellitus Therefore, the therapist prioritizes using the cushion to the client and persuades the patient to accept the product by discussing the merits of the infinity cushion with a low profile in enabling the customer to […]
• Diabetes Evidence-Based Project: Disseminating Results In this presentation, the involvement of mentors and collaboration with administration and other stakeholders are the preferred steps, and the idea to use social networking and web pages has to be removed.
• The Problem of Diabetes Among African Americans Taking into consideration the results of the research and the information found in the articles, the problem of diabetes among African Americans has to be identified and discussed at different levels.
• Childhood Obesity, Diabetes and Heart Problems Based on the data given in the introduction it can be seen that childhood obesity is a real problem within the country and as such it is believed that through proper education children will be […]
• Hypertension and Antihypertensive Therapy and Type 2 Diabetes Mellitus In particular, Acebutolol impairs the functions of epinephrine and norepinephrine, which are neurotransmitters that mediate the functioning of the heart and the sympathetic nervous system.
• Adult-Onset Type 2 Diabetes: Patient’s Profile Any immediate care as well as post-discharge treatment should be explained in the best manner possible that is accessible and understandable to the patient.
• Diabetes: Diagnosis and Treatment The disease is characterized by the pancreas almost not producing its own insulin, which leads to an increase in glucose levels in the blood.
• How to Manage Type 2 Diabetes The article is significant to the current research problem as the researchers concluded that the assessment of metabolic processes in diabetic patients was imperative for adjusting in the management of the condition.
• Type 2 Diabetes Analysis Thus, type 2 diabetes has medical costs, or the difficulties of coping up with the illness, economic ones, which are the financial costs of managing it, and the organizational ones for the healthcare systems.
• Clinical Trial of Diabetes Mellitus On the other hand, type II diabetes mellitus is caused by the failure of the liver and muscle cells to recognize the insulin produced by the pancreatic cells.
• Diabetes: Diagnosis and Related Prevention & Treatment Measures The information presented on the articles offers an insight in the diagnosis of diabetes among various groups of persons and the related preventive and treatment measures. The study identified 3666 cases of initial stages of […]
• Reinforcing Nutrition in Schools to Reduce Diabetes and Childhood Obesity For example, the 2010 report says that the rates of childhood obesity have peaked greatly compared to the previous decades: “Obesity has doubled in Maryland over the past 20 years, and nearly one-third of youth […]
• The Connection Between Diabetes and Consuming Red Meat In light of reporting the findings of this research, the Times Healthland gave a detailed report on the various aspects of this research.
• Synthesizing the Data From Relative Risk Factors of Type 2 Diabetes Speaking of such demographic factors as race, the white population suffers from it in the majority of cases, unlike the rest of the races, the remaining 0.
• Using Exenatide as Treatment of Type 2 Diabetes Mellitus in Adults Kendal et al.analyzed the effects of exenatide as an adjunct to a combination of metformin and sulfonylurea against the combination of the same drugs without the adjunct.
• Enhancing Health Literacy for People With Type 2 Diabetes Two professionals, Andrew Long, a professor in the school of heath care in the University of Leeds, and Tina Gambling, senior lecturer in the school of health care studies from the University of Cardiff, conducted […]
• The Scientific Method of Understanding if Coffee Can Impact Diabetes The hypothesis of the experiment ought to be straightforward and understandable. The control group and the experiment group for the test are then identified.
• Gestational Diabetes Mellitus: Review This is because of the current patterns that show an increase in the prevalence of diabetes in offspring born to mothers with GDM.
• Health Service Management of Diabetes
• Necrotizing Fasciitis: Pathophysiology, Role of Diabetes
• The Benefits of Sharing Knowledge About Diabetes With Physicians
• Gestational Diabetes Mellitus – NSW, Australia
• Health and Wellness: Stress, Diabetes and Tobacco Related Problems
• 52-Year-Old Female Patient With Type II Diabetes
• Healthy People Project: Personal Review About Diabetes
• Nursing Diagnosis: Type 1 Diabetes & Hypertension
• Nursing Care Development Plan for Diabetes and Hypertension
• Coronary Heart Disease Aggravated by Type 2 Diabetes and Age
• Diabetes as the Scourge of the 21st Century: Locating the Solution
• Psychosocial Implications of Diabetes Management
• Gestational Diabetes in a Pregnant Woman
• Diabetes Mellitus: Prominent Metabolic Disorder
• Holistic Approach to Man’s Health: Diabetes Prevention
• Holistic Image in Prevention of Diabetes
• Educational Strategies for Diabetes to Patients
• Diabetes and Obesity in the United Arab Emirates
• Epidemiological Problem: Diabetes in Illinois
• Diabetes as a Chronic Condition
• Managing Diabetes Through Genetic Engineering
• Diabetes, Functions of Insulin, and Preventive Practices
• Treating of Diabetes in Adults
• Counseling and Education Session in Type II Diabetes
• Diabetes II: Reduction in the Incidence
• Community Health Advocacy Project: Diabetes Among Hispanics
• Community Health Advocacy Project: Hispanics With Diabetes
• Hispanics Are More Susceptible to Diabetes That Non-Hispanics
• Rates Diabetes Between Hispanics Males and Females
• Diabetes Mellitus and HFSON Conceptual Framework
• Prince Georges County Community Health Concern: Diabetes
• Fats and Proteins in Relation to Type 2 Diabetes
• Alcohol Interaction With Medication: Type 2 Diabetes
• Diabetes Management and Evidence-Based Practice
• Critical Analysis of Policy for Type 2 Diabetes Mellitus in Australia
• The Treatment and Management of Diabetes
• Obesity and Diabetes: The Enemies Within
• Impact of Diabetes on the United Arab Emirates’ Economy
• Childhood Obesity and Type 2 Diabetes
• Health Nursing and Managing Diabetes
• Diabetes Management: How Lifestyle, Daily Routine Affect Blood Sugar
• Diabetes Management: Diagnostics and Treatment
• Diabetes Mellitus Type 2: The Family Genetic History
• Diabetes Type II: Hormonal Mechanism and Intracellular Effects of Insulin
• Social, Behavioral, and Psychosocial Causes of Diseases: Type 2 Diabetes
• Supportive Intervention in the Control of Diabetes Mellitus
• Enhancing Foot Care Practices in Patients With Diabetes
• Community Health Promotion: The Fight Against Diabetes in a Community Setting
• Diabetes in Australia and Saudi Arabia
• Diabetes: The Advantages and Disadvantages of Point of Care Testing
• Diabetes Mellitus Type 2 or Non-Insulin-Dependent Diabetes Mellitus
• Qualitative Research in Diabetes Management in Elderly Patient
• Diabetes Prevention Measures in the Republic of the Marshall Islands
• Impact of Diabetes on Healthcare
• Gestational Diabetes: American Diabetes Association Publishers
• Health Promotion: Diabetes Mellitus and Comorbidities
• Gestational Diabetes: Child Bearing Experience
• Diabetes Mellitus Effects on Periodontal Disease
• Diabetes Type II Disease in the Community
• The Relationship of Type 2 Diabetes and Depression
• Glycemic Control in Individuals With Type 2 Diabetes
• The Diagnosis of Diabetes in Older Adults and Adolescents
• Physical Activity in Managing Type-2 Diabetes
• High Risk of Developing Type 1 and Type 2 Diabetes Mellitus
• Children With Type 1 Diabetes in Clinical Practice
• Type 2 Diabetes Treatment Analysis
• Type 2 Diabetes Mellitus: Revealing the Diagnosis
• The Type 2 Diabetes Prevention: Lifestyle Choices
• Indigenous and Torres Strait Population and Diabetes
• Interpretation of the Diabetes Interview Transcript
• Type 1 Diabetes: Using Glucose Monitoring in Treatment
• Managing Type 2 Diabetes Patients’ Blood Sugar Prior to and After Surgical Procedures
• Dubai Diabetes… We Care: Leaflet Review
• Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes: Medical Terminology Definition
• Modern Diabetes Treatment Tools
• Diabetes: Encapsulation to Treat a Disease
• Current Dietary for the Treatment of Diabetes
• Diabetes: Discussion of the Disease
• Stranahan on Diabetes Impairs Hippocampal Function
• A Clinical-Based Study of Young Adults Who Have Diabetes
• Panax Ginseng for Diabetes Treatment
• Depression and Diabetes Association in Adults
• Is There Anu Cure For Diabetes?
• Diabetes Type 2 in Children: Causes and Effects
• Type 1 Diabetes Mellitus Case
• Health, Culture, and Identity as Diabetes Treatment Factors
• Diabetes Prevention in Chinese Elderly in Hunan
• “Experiences of Patients With Type 2 Diabetes Starting Insulin Therapy” by Phillips
• Type 2 Diabetes: Nursing Change Project
• Diabetes and Health Promotion Concepts
• Type 2 Diabetes Project Results Dissemination
• Type 2 Diabetes in Geriatric Patients
• Type 2 Diabetes and Geriatric Evidence-Based Care
• Cultural Empowerment. Diabetes in Afro-Americans
• Diabetes Self-Management: Relationships & Expectations
• Diagnosis and Classification of Diabetes Mellitus
• Improving Comprehensive Care for Patients With Diabetes
• Diabetes Impact on Cardiovascular and Nervous Systems
• Side Effects of Metformin in Diabetes Treatment
• Type 2 Diabetes and Drug Treatments
• Diabetes Mellitus and Health Determinants
• Nursing Leadership in Diabetes Management
• Diabetes Education for African American Women
• Latent Autoimmune Adult Diabetes
• Obesity: Epidemiology and Health Consequences
• Diabetes in Urban Cities of United States
• Diabetes in Australia: Analysis
• Type 2 Diabetes in the Afro-American Bronx Community
• Type 2 Diabetes From Cultural and Genetic Aspects
• Type 2 Diabetes in Bronx: Evidence-Based Practice
• Type 2 Diabetes in Bronx Project for Social Change
• Cardiovascular Care in Type 2 Diabetes Patients
• Ambition Diabetes and Diet on Macbeths’ Example
• Diabetes as Community Health Issue in the Bronx
• Diabetes Management Plan: Diagnosis and Development
• Diabetes Treatment and Care
• Transition from Pediatric to Adult Diabetes Care
• Diabetes Awareness Program and Strategic Planning
• Diabetes: Disease Control and Investigation
• Diabetes Pain Questionnaire and Patient Feedback
• Perception of Diabetes in the Hispanic Population
• Clinical Studies of Diabetes Mellitus
• Diabetes Mellitus and Problems at Work
• Diabetes in the US: Cost Effectiveness Analysis
• Diabetes Investigation in Space Flight Research
• Diabetes Care Advice by Food and Drug Administration
• Artificial Intelligence for Diabetes: Project Experiences
• Chronic Care Model for Diabetes Patients in the UAE
• Diabetes Among British Adults and Children
• Endocrine Disorders: Diabetes and Fibromyalgia
• Future Technologies: Diabetes Treatment and Care
• Epidemiology of Type 1 Diabetes
• Diabetes: Treatment Technology and Billing
• Pathophysiology of Mellitus and Insipidus Diabetes
• Cure for Diabetes: The Impossible Takes a Little Longer
• Stem Cell Therapy as a Potential Cure for Diabetes
• Stem Cell Therapy and Diabetes Medical Research
• Type II Diabetes Susceptibility and Socioeconomic Status
• Obesity and Hypertension in Type 2 Diabetes Patients
• Strongyloides Stercoralis Infection and Type 2 Diabetes
• Socioeconomic Status and Susceptibility to Type II Diabetes
• Diabetes Mellitus: Differential Diagnosis
• Diabetes Disease in the USA Adults
• Education for African Americans With Type 2 Diabetes
• Diabetes Treatment and Funding in Fulton County
• Diabetes Care: Leadership and Strategy Plan
• Diabetes Mellitus’ New Treatment: Principles and Process
• Diet and Nutrition: European Diabetes
• Preventing the Proliferation Diabetes
• Diabetes: Symptoms, Treatment, and Prevention
• Diabetes and Cardiovascular Diseases in Medicine
• Ecological Models to Deal with Diabetes in Medicine
• Different Types of Diabetes Found in Different Countries
• Analysis of Program “Prevent Diabetes Live Life Well”
• The Effect of Physical, Social, and Health Variables on Diabetes
• Micro and Macro-Cosmos in Medicine and Care Models for Prevention of Diabetes
• Why Qualitative Method Was Chosen for Diabetes Program Evaluation
• Humanistic Image of Managing Diabetes
• Diabetes mellitus Education and hemoglobin A1C level
• Obesity, Diabetes and Heart Disease
• Illuminate Diabetes Event Design
• Cause and Diagnosis of Type 2 diabetes
• Patient Voices: Type 2 Diabetes. Podcast Review
• Type I Diabetes: Pathogenesis and Treatment
• Human Body Organ Systems Disorders: Diabetes
• Age Influence on Physical Activity: Exercise and Diabetes
• Hemoglobin A1C Test for Diabetes
• Why Injury and Diabetes Have Been Identified as National Health Priority?
• What Factors Are Involved in the Increasing Prevalence of Type II Diabetes in Adolescents?
• Does the Socioeconomic Position Determine the Incidence of Diabetes?
• What Are the Four Types of Diabetes?
• How Fat and Obesity Cause Diabetes?
• How Exercise Affects Type 2 Diabetes?
• How Does the Treatment With Insulin Affect Type 2 Diabetes?
• How Diabetes Does Cause Depression?
• Does Diabetes Prevention Pay For Itself?
• How Does Snap Participation Affect Rates of Diabetes?
• Does Overeating Sugar Cause Diabetes, Cavities, Acne, Hyperactivity and Make You Fat?
• Why Diabetes Mellitus and How It Affects the United States?
• Does Alcohol Decrease the Risk of Diabetes?
• How Does a Person With Diabetes Feel?
• Does Periodontal Inflammation Affect Type 1 Diabetes in Childhood and Adolescence?
• How Can the Paleolithic Diet Control Type 2 Diabetes?
• How Does Insulin Help Diabetes Be Controlled?
• Does Economic Status Matter for the Regional Variation of Malnutrition-Related Diabetes?
• How Can Artificial Intelligence Technology Be Used to Treat Diabetes?
• What Are the Main Causes and Treatments of Diabetes?
• What Evidence Exists for Treatments Depression With Comorbid Diabetes Using Traditional Chinese Medicine and Natural Products?
• Why Was Qualitative Method Chosen for Diabetes Program Evaluation?
• What Are the Three Types of Diabetes?
• How Does Poverty Affect Diabetes?
• What Is the Leading Cause of Diabetes?
• How Is Diabetes Diagnosed?
• What Are the Main Symptoms of Diabetes?
• How Diabetes Adversely Affects Your Body?
• What Are the Most Common Symptoms of Undiagnosed Diabetes?
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Essay on Diabetes for Students and Children

500+ words essay on diabetes.

Diabetes is a very common disease in the world. But people may never realize, how did they get diabetes and what will happen to them and what will they go through. It may not be your problem but you have to show respect and care for the one who has diabetes. It can help them and also benefited you to know more about it and have a better understanding of it. Diabetes is a metabolic disorder which is identified by the high blood sugar level. Increased blood glucose level damages the vital organs as well as other organs of the human’s body causing other potential health ailments.

Types of Diabetes

Diabetes  Mellitus can be described in two types:

Description of two types of Diabetes Mellitus are as follows

1) Type 1 Diabetes Mellitus is classified by a deficiency of insulin in the blood. The deficiency is caused by the loss of insulin-producing beta cells in the pancreas. This type of diabetes is found more commonly in children. An abnormally high or low blood sugar level is a characteristic of this type of Diabetes.

Most patients of type 1 diabetes require regular administration of insulin. Type 1 diabetes is also hereditary from your parents. You are most likely to have type 1 diabetes if any of your parents had it. Frequent urination, thirst, weight loss, and constant hunger are common symptoms of this.

2) Type 2 Diabetes Mellitus is characterized by the inefficiency of body tissues to effectively respond to insulin because of this it may be combined by insulin deficiency. Type 2 diabetes mellitus is the most common type of diabetes in people.

People with type 2 diabetes mellitus take medicines to improve the body’s responsiveness to insulin or to reduce the glucose produced by the liver. This type of diabetes mellitus is generally attributed to lifestyle factors like – obesity, low physical activity, irregular and unhealthy diet, excess consumption of sugar in the form of sweets, drinks, etc.

Get the huge list of more than 500 Essay Topics and Ideas

Causes of Diabetes

By the process of digestion, food that we eat is broken down into useful compounds. One of these compounds is glucose, usually referred to as blood sugar. The blood performs the job of carrying glucose to the cells of the body. But mere carrying the glucose to the cells by blood isn’t enough for the cells to absorb glucose.

This is the job of the Insulin hormone. Pancreas supply insulin in the human body. Insulin acts as a bridge for glucose to transit from blood to the body cells. The problem arises when the pancreas fails to produce enough insulin or the body cells for some reason do not receive the glucose. Both the cases result in the excess of glucose in the blood, which is referred to as Diabetes or Diabetes Mellitus.

Symptoms of Diabetes

Most common symptoms of diabetes are fatigue, irritation, stress, tiredness, frequent urination and headache including loss of strength and stamina, weight loss, increase in appetite, etc.

Levels of Diabetes

There are two types of blood sugar levels – fasting blood sugar level and postprandial blood sugar level. The fasting sugar level is the sugar level that we measure after fasting for at least eight hours generally after an overnight fast. Blood sugar level below 100 mg/dL before eating food is considered normal. Postprandial glucose level or PP level is the sugar level which we measure after two hours of eating.

The PP blood sugar level should be below 140 mg/dL, two hours after the meals. Though the maximum limit in both the cases is defined, the permissible levels may vary among individuals. The range of the sugar level varies with people. Different people have different sugar level such as some people may have normal fasting sugar level of 60 mg/dL while some may have a normal value of 90 mg/dL.

Effects of Diabetes

Diabetes causes severe health consequences and it also affects vital body organs. Excessive glucose in blood damages kidneys, blood vessels, skin resulting in various cardiovascular and skin diseases and other ailments. Diabetes damages the kidneys, resulting in the accumulation of impurities in the body.

It also damages the heart’s blood vessels increasing the possibility of a heart attack. Apart from damaging vital organs, diabetes may also cause various skin infections and the infection in other parts of the body. The prime cause of all type of infections is the decreased immunity of body cells due to their inability to absorb glucose.

Diabetes is a serious life-threatening disease and must be constantly monitored and effectively subdued with proper medication and by adapting to a healthy lifestyle. By following a healthy lifestyle, regular checkups, and proper medication we can observe a healthy and long life.

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Free Essay On Type 1 Diabetes Mellitus

Type of paper: Essay

Topic: Health , Medicine , Children , Nursing , Family , Blood , Diabetes , Disease

Words: 2750

Published: 12/30/2019

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The global burden of diabetes is high and the prevalence of diabetes is increasing. Diabetes is a major disease with significant side effects and complications resulting in shorter lifespans. The problem is greater with type 1 diabetes because this type of diabetes cannot be prevented and there is no cure for the disease. However, clinical studies have shown that education, adapting to the disease, and nutritional therapy can reduce the complications of type 1 diabetes. Parents are the most important members of the diabetes management team in pediatric patients and any impact on the quality of life of the parent affects the quality of care of the diabetic child.

Type 1 Diabetes Mellitus

The global burden of diabetes is significant. The World Health organization (WHO) estimates that 346 million people have diabetes worldwide, with a mortality rate of 10% recorded for 2004 (WHO, 2011). However, there are wide variations in the prevalence and mortality rate of diabetes among countries. Over 80% of all deaths from the complications of diabetes occur in underdeveloped and transitioning countries and this rate is projected to double by 2030 (WHO, 2011). The countries with the largest number of people with diabetes are India (50.8 million), China (43.2 million), and the United States (26.8 million). In contrast, Australia had 700,000 people diagnosed with diabetes in 2004-2005 (WHO, 2011). However, although the prevalence of diabetes in Australia is not as high as in other countries, diabetes represents a great burden to the healthcare system of Australia, especially in the treatment of indigenous people, where the death rate has be shown to be as high as 12 times that in the non-indigenous diabetic population (AIHW, 2008). In addition, the death rate from renal complications in indigenous people was found to be 19 times higher than in the general diabetic population, and deaths from other complications such as coronary heart disease, stroke, peripheral artery disease, and ulcers in the lower extremities were 7% higher (AIHW, 2008). There are also race and ethnic differences in the prevalence of diabetes in the US, ranging from 7.1% for non-Hispanic whites, t 11.8% for Hispanics, and 12.6% for non-Hispanic blacks (WHO, 2011).

Causes, Rate, and Risk Factors of Diabetes

During the process of digestion food is broken down into glucose, simple sugar. Glucose is then removed from the blood by insulin, a hormone made by the pancreas, and taken into the cells. Hyperglycemia, or high blood sugar levels, occurs when the pancreas cannot produce enough insulin to remove glucose from the blood or because the cells are not able to use the insulin (Centers for Disease Control (CDC), 2011). People with hyperglycemia can develop serious medical conditions should the disease progresses without medication (CDC, 2011).

There are different types of diabetes, which are classified according to their causes and risk factors. Type 1 diabetes is a chronic condition where the pancreas cannot make insulin to remove glucose from the blood and the patient develops hyperglycemia. With type 2 diabetes, the pancreas is either not making enough insulin or the cells lack the ability to use insulin.

Type 1diabetes, or diabetes mellitus, used to be referred to as child onset diabetes since the majority of patients diagnosed with type 1 diabetes were children and adolescents, although people can develop type 1 diabetes at any age (A.D.A.M.). The global incidence of childhood type 1 diabetes mellitus (T1DM) is increasing; although, as in all other forms of diabetes, there are wide variations among the different countries (Taplin et al., 2005). Some attribute the increase to environmental factors while others attribute it to genetic factors. The high-risk human leukocyte antigen (HLA) class II DRB1 gene has been shown to be commonly expressed in people with type 1 diabetes. However, a study by Fourlanos et al. (2008) has shown that the impact of the environment on lower-risk HLA class II genes can raise the incidence of type 1 diabetes in children who previously would not have developed type 1 diabetes. Another study found a correlation between maternal history of Type 1 and Type2 diabetes and later onset of Type 1 diabetes (Holstein et al., 2012). The study also found that people with type 1 diabetes have lower fertility rates.

Standards of Care for Children and Adolescents with Type 1 Diabetes

There is no known cause and no cure for Type 1 diabetes but the disease can be managed with diet, regular exercise, maintaining a normal body weight, and medication (CDC, 2011). Type 1 diabetes is diagnosed when a patient presents with a history of symptoms of diabetes, such as excessive urination, thirst and hunger, weight loss, and when laboratory tests confirm hyperglycemia, glycosuria, ketonemia, and ketonuria (Silverstein, 2005). In the absence of these symptoms, hyperglycemia alone does not indicate diabetes; however, when a patient who is otherwise healthy presents with high blood sugar levels, other tests are generally conducted to confirm or rule out diabetes. One of these tests is the hemoglobin A1C blood test; when this test shows levels higher than 6.5%, that means that the patient has diabetes. Another test is the oral glucose tolerance test; diabetes is confirmed if sugar levels are greater than 200 mg/dL after 2 hours. Type 1 diabetes is diagnosed in 10%–15% of people with diabetes and a great majority of these patients are children or adolescents.

Short-term Care

The first step in the management of child or adolescent diabetes is to have the patient evaluated by a multidisciplinary team consisting of a pediatric endocrinologist, nurse educator, nutritionist, and psychologist (Silverstein et al., 2005). As the child advances through the various stages of childhood and adolescence the team has to make adjustments to the treatment protocol to correspond with developmental changes. Around 30% of children with type 1 diabetes suffer from diabetic ketoacidosis (DKA), a life-threatening condition that needs immediate attention.

Medication is a critical component in the management of type 1 diabetes as the body cannot produce any insulin. There is also a strong educational component in the control his disease; therefore, a critical first step in the care of diabetes is patient education (Silverstein et al., 2005). This is particularly important as there is no cure for the disease and self-management is at the core of treatment. Parents with diabetic children must adapt and learn the skills necessary to help their children live with the disease and as they learn these skills they must also pass this knowledge on to their children (Holstein et al., 2012).

Long-term Care

Type 2 diabetes can be prevented through proper nutrition and regular exercise; however, there is no way to prevent or cure type 1 diabetes (A.D.A.M., CDC, 2011). Patients with either form of diabetes should wear an identification bracelet that identifies the wearer as a person with diabetes. This is especially true for school-age pediatric patients who are often away from their parents. The ability of children to manage diabetes on their own varies according to their motor development, cognitive ability, and maturity and increases with time. Parenting of children with type 1 diabetes can be stressful because the disease has to be monitored closely to ensure metabolic control and to prevent drops in blood-sugar levels. This is especially true in the oversight of infants who have no way of communicating or responding to the danger signals of the disease (Grey et al., 2011). Therefore, it follows that parents of children diagnosed with diabetes carry a large burden of care that often leads chronic stress and depression; and unfortunately, there are few interventions available to help parents cope with the challenges of caring for a diabetic child. It is critical to address this issue because the ability to cope with the stress of treating diabetes in a child can impact the management of the disease as well as the wellbeing of the entire family unit; and the ability to teach the child, when mature enough, to self-manage the disease. Studies have shown that parental depression correlates with poor metabolic control and low quality of life (QOL) of parent and child (Grey et al, 2011). One way to ameliorate this problem is to adopt a flexible and intensive approach to the management of insulin that would not only improve metabolic control but also result in dietary freedom. This approach has been made possible by the advent of new medications in the form of insulin analogues, although their use requires personalized and extensive parental education. As the child matures and the parent adjusts to the disease the diabetes care management team should develop a plan that meets the needs, hopes, and lifestyle of the young patient and the parents.

Diseases associated with diabetes

Diabetes is a serious disease that reduces QOL and has serious complications. More than half of the patients diagnosed with diabetes suffer from other disabilities and 25% of these disabilities were a direct cause of diabetes (AIHW, 2008). Diseases associated with diabetes include diseases of the kidney, various cardiovascular and neurological diseases, eye problems, and stroke (A.D.A.M.). Cardiovascular disease and stroke account for half the mortality rate of people with diabetes. Impaired circulation and neuropathy in the lower limbs raise the risk of foot ulcers that sometimes lead to limb amputation. Poor circulation can lead to damage of the small blood vessels feeding the retina and diabetic retinopathy, which may eventually lead to blindness in 2%, and severe visual defects in 10%, of people with diabetes. There is also significant correlation between diabetes and renal failure and 10-20% of people with diabetes die due to kidney complications. Neurological damage is also common among people with diabetes and this can lead to pain and loss of sensation and function in the hands and feet. Finally, the overall risk of mortality among diabetics is over twice that of people in the general population.

Endothelial function plays a critical role in the progression of diabetes and is not just limited to the anatomy of the blood vessels but also involves their function. The blood vessels are responsible for the delivery of inflammatory cells and cytokines, and other regulatory substances to the various cells; thus, impaired anatomy translates into impaired function and vascular disease (Gallego, Wiltshire & Donaghue, 2007). Endothelial dysfunction leads to microalbuminuria, which signals the beginning of diabetic nephropathy. There are many factors that lead to impaired endothelia function in patients with type 1diabetes including high blood-sugar levels, low insulin levels, and elevated LDL cholesterol levels. High blood-sugar levels acts either directly, or indirectly via the activation of regulatory pathways, to compromise the function of blood vessels; while insulin can act directly by increasing the blood flow (Gallego, Wiltshire & Donaghue, 2007). Therefore, since endothelial dysfunction precedes diabetes-induced complications, it is critical to assess endothelial function even when there is no evidence of any such complications. The factors affecting endothelial function vary for young and older adults. In younger adults there is a correlation between LDL cholesterol levels and endothelial dysfunction, whereas in older adults the correlation is between microalbuminuria and flow-mediated dilatation (FMD). Once the factor that is causing impaired endothelial function has been isolated, the issue may be addressed with therapy; for example, FMD can be treated with nutritional supplements like folate of vitamin B6, LDL cholesterol can be controlled with statins, and high blood-sugar levels can be managed with insulin.

There is scientific evidence that control of modifiable risk factors such as blood sugar levels, cholesterol levels and blood pressure can lower the risk of complications due to diabetes. Proper nutrition can help control hyperglycemia, lower cholesterol and keep blood pressure within normal levels. To accomplish this it is critical to have a strong medical support system, especially as patients with type 1 diabetes transition from child hood to adulthood. Perry et al. (2011) found that young adults with type 1 diabetes were not receiving proper diabetes services in rural areas of New South Wales, Australia; they reported that the patient either had not access to diabetic care, or the care offered was inadequate and not age specific. There was a wide gap in the level of care and in the services the patients with diabetes received in childhood and in adulthood; patients felt they had been abandoned by the healthcare system, citing fragmentation of care, lack of coordinated care, and minimal support. This gap in the healthcare system in rural Australia may account for the higher prevalence of diabetes, complications from diabetes, and death among diabetic people in the lower socioeconomic groups, which is nearly double the rate in diabetic people in the higher socioeconomic groups (AIHW, 2008).

Living with diabetes is stressful at best; once diagnosed with the disease the patient knows that permanent life-style adjustments are to be made in order to live with the disease. However, if the disease is caught early, the patient cooperates with the diabetes management team and learns about the disease, the impact on quality of life can be minimized. The quality of care of a child with type 1 diabetes depends on the ability of the parent to adapt to the challenges of caring for the disease. The primary end of this study is to evaluate factors that affect parental care of type 1 diabetes mellitus.

A.D.A.M. Medical Encyclopedia. Diabetes. Access at:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/ Australian Institute of Health and Welfare (2008). Diabetes: Australian Facts. Diabetes series No. 8, Cat. No. CVD 40. Canberra: AIHW. Centers for Disease Control (2011). National Diabetic Fact Sheet, 2011. Access at:

http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf

Fourlanos, S., Varney, M. D., Tait, B. D., Morahan, G., Honeyman, M. C., Colman, P. G., & Harrison, L. C. (2008) The rising incidence of type 1 diabetes is accounted for by cases with lower-risk human leukocyte antigen genotypes. Diabetes Care 31(8):1546-9. Gallego, P. H., Wiltshire, E., & Donaghue, K. C. (2007). Identifying children at particular risk of long-term diabetes complications, Pediatric diabetes 8 (Suppl.6): 40-48 Grey, M., Jaser, S.S., Whittermore, R., Jeon, S., & Lindermann, E. (2011) Coping Skills Training for Parents of Children with Type 1 Diabetes: 12-Month Outcomes, Nursing Research 60(3):173-81 Holstein, A., Patzer, O., Tiemann, T., Vortherms, J., Kovacs, P. (2012) Number and sex ratio of children and impact of parental diabetes in individuals with Type1 diabetes. Diabetic Medicine. doi: 10.1111/j.1464-5491.2012.03618.x. Perry, L., Lowe, J.M., Steinbeck, K. S., & Dunbabin, J. S. (2012). Services doing the best they can: service experiences of young adults with type 1 diabetes mellitus in rural Australia. Journal of Clinical Nursing 21(13-14):1955-63. doi: 10.1111/j.1365-2702.2011.04012.x. Silverstein, J., Klingensmith, G., Copeland, K., Plotnick, L., Kaufman, F., Laffel, L., Deeb, L., Grey, M., Anderson, B., Holzmeister, L. A., et al. (2005) Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care. 28(1):186-212. Taplin, C. E., Craig, M. E., Lloyd, M,, Taylor, C.; et al (2005). The rising incidence of childhood type 1 diabetes in New South Wales, 1990-2002. Medical Journal of Australia; 183, 5

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Home — Application Essay — Engineering Schools — Living with Diabetes: College Admission Essay Sample

Living with Diabetes: College Admission Essay Sample

• University: Wentworth Institute of Technology

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Published: Jul 18, 2018

Words: 463 | Pages: 1 | 3 min read

Being in a hospital is not a pleasant experience, especially when the doctors are unaware of the diagnosis, and you, the patient, are left in the dark. Learning I had diabetes was an overwhelming experience, to say the least. I had gone in for a routine check up and was floored by the news; I had had no symptoms, no signs whatsoever, but there it was. I didn’t believe it, mostly because I didn’t understand it. I did not know what a pancreas was, or why it would suddenly stop working. I could not comprehend all the information and the medical jargon the doctors were throwing at me. I was lost.

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Living with diabetes is difficult and nothing was worse than the first year. I had to learn how to keep my pancreas on its best behavior, give myself a shot three times a day, and deal with my mother’s incessant neuroticism. All my relatives and friends kept telling me how horrible my situation was and they all expected me to become depressed. I merely shook it off. What are a few less snickers and ho-hos? I changed my screen name to dia-bill-ic, turned my glucose checks into a betting game and acquired a new pick up line: “slow down sugar, I’m diabetic”. I am not saying I let my disease go rampant as I am always conscious about staying healthy, but I refuse to see my diabetes as a deterrent. Every year since 2005, the year of my diagnosis, I have collected money and walked in Boston’s Walk for Diabetes fundraiser because of my faith in science. I believe a cure is coming and because of this, my anxieties and fears about my future medical condition are put at ease. I am not going to sugar coat it. Life would be much easier without diabetes, but there are more important aspects to life than an illness.

One thing diabetes has allowed me to do is put things into perspective. Sure diabetes is bad, but anywhere else in the world it could, and probably would be worse. This realization has helped me through the worst of it, (the needles, the white coats, and the constant reminders of what could happen), and has also motivated me to try to improve circumstances for those worse off than I. Recently I have been doing work with a non-profit organization that provides education for the battered and mistreated Ugandan children affected by their civil war. I am lucky to be in a country whose people are able to have a good education, food, shelter, and equally important, medical attention. Living in this environment with diabetes has nurtured my compassion for other people and strengthened my perseverance in every aspect of my life.

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Life with Type 1—A Photo Essay

When I began dating my husband Tom I couldn’t have told you the purpose of the pancreas, let alone the difference between type 1 and type 2 diabetes . An ever-growing epidemic in the United States, type 2 is typically the result of diet and lifestyle choices and is largely preventable. It’s a disease that we’ve unfortunately become accustomed to hearing about on a regular basis. But what about the millions in this country living with type 1? They seem to have been lost in the discussion.

Both diseases are a result of problems with insulin, one of the hormones the body uses to regulate blood sugar and derive energy from food. But that’s where similarities end. Very simply put, type 2 diabetes has to do with insulin resistance. The pancreas produces it, but the body doesn’t use the insulin properly. Type 2 can be managed through a combination of diet, exercise and medication before (if ever) resorting to insulin injections. Meanwhile type 1 is an autoimmune disease (often diagnosed early in life—in Tom’s case at 2 years old) in which the pancreas stops producing insulin altogether. People with type 1 diabetes rely on insulin injections to lower blood sugar. Insulin is not a cure; it simply allows a person with type 1 to stay alive.

The complications of type 1 diabetes are grave, both short and long term. Administering too much insulin can cause low blood glucose (hypoglycemia), which can lead to seizures, coma and in extreme circumstances, death. On the opposite end of the spectrum, not enough insulin can cause very high blood glucose which can lead to diabetic ketoacidosis (DKA), a life-threatening condition in which the blood becomes too acidic. The potential long-term complications are equally terrifying: blindness, kidney failure and limb amputation to name a few.

Life with type 1 is a perpetual and exhausting tightrope act. The goal is to achieve optimal blood glucose levels without going too high or too low. But despite constant finger pricks to check/re-check blood sugar, meticulous dosage and timing of insulin boluses, counting carbs and considering a myriad of other factors, it is virtually impossible to mimic the human pancreas. Factors that impact blood sugar include and are not limited to: all food (healthy or unhealthy), stress, imperfect timing and/or dosage of insulin, dehydration, exercise, weather, sleep (too much or lack of), inconsistent schedule, hormones, caffeine, illness … the list goes on.

Tempering my anxiety over Tom’s disease while being a supportive (but not overbearing) partner is something I work at on a daily basis. Lows in particular are a constant struggle for me. After having the disease for over 33 years, Tom has developed a dangerous condition called hypoglycemic unawareness in which he can no longer feel the symptoms (shakiness, lightheadedness) that serve to warn of a dropping blood sugar. I worry he’ll go too low while he’s driving, while he’s sleeping, when I’m not there. I worry about everything.

I often think about how unfair it is that people with type 1 diabetes never get a break from the burden of such complex, unrelenting disease. One can’t take a pill and forget about it for a few hours. Imagine having to manage a disease without a rulebook—it behaves differently for each person and under each circumstance. Type 1 requires attention and action 24/7, so it’s easy to understand how one might feel burned out or isolated. I’ve told my husband that I wish I could take his place, even for a single day, so he could know the freedom of life without having to think about blood sugar.

All this being said, to know Tom is to know the happiest guy on the planet. I marvel at his strength, his commitment to his health (particularly when it’s not easy, which is most of the time), his childlike joy for life. His absolute refusal to give in to bitterness. Every single day with Tom is filled with adventure and belly laughs. Yes, type 1 is always there, looming, but never able to define him. He won’t let it.

Documenting life with type 1 has been cathartic for me, and I hope can bring some awareness (however small) to the plight of all people with type 1 diabetes and their families.

A small tattoo on Tom’s right forearm with big meaning. It’s an homage to his lifeblood: C 2 5 7 H 3 8 3 N 6 5 O 7 7 S 6 is the chemical formula for the synthetic insulin he has taken for the majority of his life.

Tom filling up the reservoir of his insulin pump, which he must wear at all times. Tubing connects the pump to an insertion site on his stomach (the site needs to be moved around every few days to avoid scar tissue buildup). At the insertion site is a tiny cannula that delivers the insulin directly into his bloodstream. A healthy pancreas constantly produces basal insulin (meaning a low dose, baseline) every few minutes, 24 hours a day, and automatically increases/decreases the amount it makes based on the current amount of glucose already in the blood. It also produces bolus insulin (meaning a larger amount) when the body requires more insulin to cover the increased amount of glucose in the bloodstream when a person eats. A healthy pancreas does a remarkable job of monitoring the exact amount of insulin needed to match the glucose that enters the blood. With type 1 diabetes, the pancreas cannot produce basal or bolus insulin, so synthetic insulin must be administered either by injection, or in Tom’s case, with a pump.

The question of course, is how much insulin. The pump has been a life-changing piece of technology for Tom and so many others; until he was 15 years old he had to administer manual injections to himself. It’s important to remember, however, that the insulin pump is not an intelligent device. While it makes administering the insulin much easier, Tom must still make the decisions as far as dosing.

The contents of Tom’s diabetes supply cabinet. It isn’t entirely clear what triggers the onset of type 1 diabetes. Researchers have discovered that genetics play a role; there is an inherited predisposition. They do not, however, know exactly what sets off the immune system causing it to turn against itself and destroy the insulin-producing beta cells in the pancreas. Unlike type 2, type 1 diabetes has nothing to do with diet or lifestyle and is typically diagnosed during childhood.

Keeping my anxiety in check while Tom sleeps can be difficult for me. Is he just sleeping in? Is he conscious? Is he taking a nap because he’s genuinely tired or because he’s lethargic due to a low? I admit my worry has gotten the best of me many times. Early on in our relationship, I found myself waking him up to deliver pressing messages like “look how cute the dog is being right now” just to make sure he wasn’t dangerously low or unconscious. Needless to say, that approach didn’t go over well. Type 1 is a disease that affects the whole family, and I’m still very much a-work-in-progress when it comes to determining when is appropriate for me to act as caretaker and when I’m overstepping boundaries and need to let go.

One of the insulin pumps Tom has used over the 21 years he’s been pumping. Once it was retired, we decided to take it apart for a look at the innards. Just like this old one, his new pump is routinely mistaken for a pager and it cracks us up every time.

Here Tom is inserting the sensor for his continuous glucose monitor, or CGM. A tiny electrode measures the blood glucose levels in tissue fluid every five minutes. It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device. This recent technology has been a game changer in his management of type 1. Not only does it give Tom a ballpark idea of where his blood sugar is at, but an alarm on the monitor will sound when certain levels (high or low) are reached. The CGM is not 100 percent accurate by any means (there’s a lag when glucose moves from blood to tissue fluid so it’s not quite real time) and it doesn’t replace finger pricks (it constantly needs to be calibrated with them), but is a useful tool and potential safety net. The CGM alarm sounding like a fog horn at 3 a.m. is always a jarring, but a welcome, disruption from sleep … at least to me.

Between constant finger pricks and in the above case, accidentally hitting a blood vessel during CGM sensor insertion, it’s hard for people with type 1 diabetes not to feel like a pin cushion at times.

Type 1 is an invisible, misunderstood disease. Things people often say to Tom: “You don’t look like you have diabetes,” “But you’re thin,” “Can you eat that?”, “That stinks you can’t have sugar.” Many erroneously lump type 1 diabetes together with type 2, which is understandable (and something I did before I met Tom) due to the fact that they share the same name. Many type 1 advocates, myself included, feel that the diseases should be differentiated with unique names. There’s already so much confusion surrounding the facts about diabetes, it would help raise awareness and benefit those living with both type 1 and type 2 if the public were better informed.

Tom filling his pump with insulin and priming the tubing before insertion.

Our days are filled with yo-yoing numbers, and this is one that we don’t like to see. 65 is low enough to require treatment with fast-acting carbohydrates. I sometimes find myself hovering over the meter when Tom does a finger prick, trying to get a glimpse of the number. While my intentions are of course good, it’s important to remind myself to respect Tom’s space and his ability to manage it on his own. It’s his body, after all, and he survived most of his life just fine without me. I once heard type 1 likened to a stepchild for a spouse, a comparison that resonated with me. While it will always be a part of my life and it’s important for me to be involved to a certain extent, type 1 will always be Tom’s baby and his alone.

Juice boxes are the go-to treatment for lows so Tom knows exactly how many carbs he’s taking in with each one.

Tom participating as a subject in an artificial pancreas study at the University of Chicago. Researchers are working to develop an algorithm that links the insulin pump to the CGM, while automatically delivering the appropriate amount of insulin making it a fully automated process. The artificial pancreas could potentially ease the burden of people with type 1 diabetes in a monumental way, allowing them not to have to think about their blood glucose 24/7. It wouldn’t be a cure, but the next best thing.

Apple juice to the rescue.

Tom spent 72 hours in the hospital monitoring his blood sugar every five minutes, with a team of researchers sitting beside the bed (even while he slept) working on the algorithm.

The unicorn: a constant straight line of stable blood sugar readings on Tom’s CGM monitor.

Type 1 is a cruel, demanding disease. You can do everything right and still get an inexplicable blood sugar. It’s easy to blame yourself, get down about it and stress about the potential complications. What’s more important, as Tom has taught me, is to live life on your own terms. The straight line above is yes, something to be celebrated, but not something to be expected on an average day with type 1. That’s the thing, there IS no average day. All you can do is your best, and meanwhile enjoy life.

This article was originally published on  Anne Marie Moran’s blog.

Want to spread awareness?  Become an ambassador at Beyond Type 1 . Click the button to learn all the ways you can become involved in Beyond Type 1’s global community!

WRITTEN BY Anne Marie Moran, POSTED 09/14/16, UPDATED 04/03/24

Bionic boy -, diabetes news -, t1d subway nightmare -, what is type 2 diabetes -, signs of type 1 diabetes -.

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