How common is delayed type 1 diabetes diagnosis in children?

From diabetesincontrol.com

A delayed type 1 diabetes diagnosis can allow early warning signs to progress into a medical emergency. Yet children with excessive thirst, frequent urination, and unexplained weight loss may leave healthcare visits without the correct diagnosis. Why do these familiar symptoms go unnoticed? A scoping review of 27 studies reveals troubling gaps in clinical recognition, testing, and diabetes classification. The findings highlight opportunities for healthcare professionals to identify type 1 diabetes earlier and reduce potentially preventable diabetic ketoacidosis (DKA).

What Research Reveals About Delays in Diagnosing Type 1 Diabetes

A scoping review published October 12, 2026, in BMC Paediatrics examined delayed diagnosis and misdiagnosis among children and adolescents with type 1 diabetes. Researchers analysed 27 studies selected from 1,936 screened records.

The published scoping review reported substantial variation in diagnostic delays across healthcare settings.

Among studies that did not separate patients by DKA status, delayed diagnosis occurred in 14.1% to 46.6% of cases. Meanwhile, 16.0% to 38.7% of patients had their diagnosis missed during their first healthcare contact.

For patients presenting with DKA, reported diagnostic delays ranged from 43.0% to 98.1%. However, these figures reflect different study populations, definitions, and measurement methods.

Importantly, they should not be interpreted as a single overall rate of missed diagnoses.

The review also identified diabetes-type misclassification rates ranging from 1.4% to 22.7%.

Together, these findings suggest that diagnostic uncertainty remains a significant challenge in paediatric diabetes care. Furthermore, the review identified missed symptoms, incorrect symptom interpretation, and problems with laboratory testing as recurring clinical errors.

Common Type 1 Diabetes Symptoms Clinicians May Overlook

Early type 1 diabetes symptoms can resemble common childhood illnesses. Consequently, healthcare professionals may initially consider other explanations.

Frequent urination may be mistaken for a urinary tract infection. Increased thirst can appear related to warm weather, exercise, or dehydration. Similarly, fatigue and weight loss may be attributed to infection, stress, or changing eating habits.

However, these symptoms become more concerning when they appear together.

Classic warning signs include excessive thirst, frequent urination, night-time bedwetting after previously staying dry, unexplained weight loss, increased hunger, and persistent tiredness.

Younger children may present additional diagnostic challenges because they cannot clearly describe their symptoms.

As insulin deficiency progresses, nausea, vomiting, abdominal pain, and rapid breathing may develop. Unfortunately, these symptoms can resemble gastrointestinal or respiratory illnesses.

Because these symptoms overlap with other childhood illnesses, clinicians may overlook type 1 diabetes, particularly when blood glucose testing is not performed.

For healthcare professionals, symptom patterns matter more than any single complaint. A child with unusual thirst, frequent urination, and weight loss warrants prompt diabetes evaluation, even when another illness seems possible.

Why Diagnostic Mistakes and Diabetes Misclassification Matter

Missing the initial diagnosis is only one concern. Incorrectly identifying the type of diabetes can also delay appropriate treatment.

The review found that type 1 diabetes and type 2 diabetes were sometimes confused, particularly when clinical presentations were unusual.

For example, clinicians may associate excess body weight with type 2 diabetes. However, children with overweight or obesity can also develop autoimmune type 1 diabetes.

Conversely, some young patients with type 2 diabetes may present with ketosis or DKA. Therefore, neither body weight nor DKA alone establishes diabetes type.

The 2024 ISPAD clinical guidelines emphasize evaluating clinical characteristics and pancreatic autoantibodies when distinguishing diabetes types.

Tests for GAD65, IA-2, and other islet autoantibodies can support classification when appropriate. C-peptide testing may also help assess insulin production in the right clinical setting.

However, clinicians should not delay urgent insulin treatment while awaiting classification results in a patient with suspected significant insulin deficiency.

Misclassification can lead to inappropriate treatment decisions and prolonged hyperglycemia. In severe cases, insufficient insulin treatment may contribute to DKA.

Previous Diabetes in Control coverage of type 1 diabetes diagnosis similarly emphasized that autoimmune diabetes can occur in patients with obesity.

These findings reinforce the importance of clinical assessment rather than assumptions based on appearance or age.

How Earlier Recognition Can Help Prevent Diabetic Ketoacidosis

Avoiding delays in diagnosing type 1 diabetes starts with recognizing warning signs and ordering timely glucose testing.

For children with classic symptoms, prompt blood glucose assessment provides a practical starting point. Point-of-care glucose testing can identify concerning hyperglycaemia immediately, while laboratory plasma glucose testing supports formal diagnosis.

A random plasma glucose of at least 200 mg/dL (11.1 mmol/L) in a patient with classic symptoms meets established diagnostic criteria.

Additionally, ketone testing is essential when insulin deficiency or DKA is suspected.

Children experiencing vomiting, abdominal pain, dehydration, deep breathing, or altered mental status require urgent evaluation for DKA. Assessment may include blood ketones, electrolytes, and acid-base status.

Importantly, clinicians should not wait for HbA1c results before addressing a suspected metabolic emergency.

Healthcare teams can also reduce diagnostic errors by improving communication between primary care, emergency departments, and paediatric diabetes specialists.

Clear referral pathways and documented follow-up plans may help prevent patients from being lost between appointments.

Patient and caregiver education remains equally important.

Families should understand that persistent thirst, frequent urination, and unexplained weight loss are not symptoms to ignore.

Earlier recognition may allow treatment before serious metabolic deterioration develops. Indeed, previous Diabetes in Control reporting on pediatric DKA prevention highlighted the value of symptom education and structured monitoring.

Although the scoping review did not establish how many DKA cases could be prevented, its findings identify important opportunities to improve clinical practice.

Conclusion

When type 1 diabetes goes unrecognized, children and adolescents face a greater risk of serious complications, including diabetic ketoacidosis.

The 27-study scoping review demonstrates that missed symptoms, inconsistent testing, and incorrect diabetes classification can contribute to diagnostic uncertainty and treatment errors.

For clinicians, the message is clear: recognize classic symptom patterns, assess glucose promptly, investigate possible DKA, and avoid relying on assumptions about diabetes type.

Better awareness, timely testing, and coordinated care may help patients receive appropriate treatment before preventable complications develop.

Frequently Asked Questions

1. What are the most commonly missed symptoms of type 1 diabetes?

Frequent urination, excessive thirst, unexplained weight loss, fatigue, and new bedwetting are important warning signs. These symptoms may be mistaken for other childhood conditions, especially when they develop gradually.

2. How common is delayed type 1 diabetes diagnosis in children?

The 2026 scoping review reported delayed diagnosis in 14.1% to 46.6% of cases in studies without DKA stratification. Rates varied significantly across populations and study methods.

3. Can type 1 diabetes be mistaken for type 2 diabetes?

Yes. Type 1 diabetes can occur in children with overweight or obesity. Clinical assessment and appropriate antibody testing can help clinicians distinguish between diabetes types.

4. Why does a missed diagnosis increase the risk of DKA?

Without sufficient insulin, the body breaks down fat and produces ketones. Rising ketone levels can cause dangerous blood acidity, dehydration, and life-threatening complications. Prompt diagnosis and treatment reduce the opportunity for this deterioration.

5. What should clinicians do when they suspect type 1 diabetes?

Healthcare professionals should promptly assess blood glucose, evaluate ketones when indicated, and arrange urgent specialist care when diabetes or DKA is suspected. Treatment of metabolic emergencies should never be delayed while awaiting diabetes-type classification.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/delayed-type-1-diabetes-diagnosis-missed-symptoms/ 

Eat, Then Exercise—or Exercise First? In Type 1 Diabetes, the Order May Matter

From diabetesincontrol.com

For people with type 1 diabetes, exercise is rarely as simple as choosing a workout and getting started. Food, insulin, glucose trends, and workout intensity can all change what happens next. New research on exercise timing in type 1 diabetes adds another piece to that puzzle. A randomized crossover trial found that glucose responses differed depending on whether exercise occurred in a post-absorptive state or after a meal, when insulin on board was higher. The results suggest that what happens before exercise may be nearly as important as the workout itself.

Why Exercise Timing in Type 1 Diabetes Matters

Exercise can produce very different glucose responses in people with type 1 diabetes. Moderate aerobic activity often lowers glucose because working muscles rapidly use glucose for energy. In contrast, intense intervals can sometimes produce a smaller decline or even a temporary rise as stress hormones increase glucose production.

However, exercise type is only part of the story. The amount of circulating insulin also matters. After a meal and mealtime insulin dose, insulin on board may remain substantial when exercise begins. As a result, muscle glucose uptake can combine with insulin action and create a sharper glucose decline.

This is why the timing of exercise can matter for people with type 1 diabetes. Two identical workouts may produce different glucose patterns depending on their relationship to food and insulin.

The American Diabetes Association notes that glucose responses can vary with starting glucose, exercise intensity, duration, and insulin adjustments. Diabetes in Control has also reviewed how different workouts affect glucose in type 1 diabetes.

What the Randomized Crossover Trial Found

The 2026 randomized crossover trial published in Diabetologia included 20 physically active adults with type 1 diabetes. Each participant completed four 25-minute cycling sessions. Researchers compared high-intensity interval exercise, or HIIE, with continuous moderate-intensity exercise under both post-absorptive and post-meal conditions.

Importantly, the exercise sessions were matched for mechanical load. The interval sessions alternated one-minute bouts at 100% of maximal aerobic power, while continuous exercise was performed at 50%.

Meal state clearly influenced the response. During exercise, capillary glucose fell less in the post-absorptive state than after a meal. Glucose also declined less during HIIE than during continuous moderate exercise. Moreover, the difference between interval and continuous exercise was strongest in the post-absorptive state.

The average glucose change was approximately -0.72 mmol/L during post-absorptive HIIE compared with -1.73 mmol/L during post-absorptive continuous exercise. After a meal, declines were larger at -2.33 mmol/L for HIIE and -2.61 mmol/L for continuous exercise.

Notably, the differences extended beyond the workout. During the following 24 hours, participants spent less time below 3.0 mmol/L after HIIE than after continuous exercise after researchers adjusted for carbohydrate intake and insulin doses. The study abstract is available through PubMed.

Insulin on Board and Exercise Intensity

Why did eating first make such a difference? Insulin on board is a likely contributor.

During the post-meal sessions, participants had higher circulating insulin. Exercise itself increases glucose uptake by working muscles. Therefore, adding significant insulin action can accelerate the movement of glucose out of the bloodstream.

High-intensity intervals create a different hormonal environment. Catecholamines and other counterregulatory hormones can stimulate the liver to release glucose. Consequently, intense exercise may partly offset the glucose-lowering effect seen during steady aerobic activity.

Still, these findings should not be interpreted as evidence that everyone with type 1 diabetes should exercise before eating or switch to HIIT. The study was small, involving only 20 physically active adults. Individual responses can also vary according to insulin delivery method, fitness, starting glucose, previous activity, carbohydrate intake, and automated insulin delivery settings.

For additional background, Diabetes in Control has discussed target glucose considerations around exercise, emphasizing that exercise type and intensity affect planning.

Applying Exercise Timing Research to Everyday Care

The practical message is personalization rather than finding one ideal time to exercise with type 1 diabetes. Clinicians may want to ask patients not only what exercise they perform, but also when they perform it relative to meals and bolus insulin.

CGM data can make these conversations more useful. For example, patients can compare glucose trends during similar workouts performed under different conditions. Recording meal timing, insulin doses, exercise intensity, and glucose direction may reveal repeatable patterns.

Additionally, patients should be aware that a stable glucose level during exercise does not eliminate the possibility of delayed hypoglycaemia. Increased insulin sensitivity can continue after activity, so post-exercise and overnight monitoring may remain important.

Current diabetes guidance emphasizes individualized carbohydrate and medication adjustments because glycaemic responses to physical activity can vary widely. Therefore, insulin changes should not be based on one study or a single workout.

People experiencing repeated exercise-related hypoglycaemia, unexplained hyperglycaemia, or difficulty adjusting insulin around workouts should discuss their patterns with their diabetes care team. Personalized medical guidance can also be found through Healthcare.pro.

Conclusion

For people with type 1 diabetes, when exercise happens can be just as important as the type of activity. Meal state, insulin on board, and workout intensity can interact to produce meaningfully different glucose responses.

In this randomized crossover trial, high-intensity interval exercise produced a smaller glucose decline than continuous moderate exercise, particularly when performed in the post-absorptive state. Meanwhile, exercising after a meal was associated with larger glucose declines across both exercise types.

These findings reinforce a practical lesson: the same workout does not always produce the same glucose response. Tracking exercise timing alongside insulin, meals, and CGM trends may help clinicians and patients develop safer and more predictable exercise strategies.

FAQs

Does exercising after a meal lower glucose more in type 1 diabetes?

In this study, glucose declined more during post-meal exercise than during exercise in the post-absorptive state. However, individual responses can vary considerably.

Is HIIT safer than moderate exercise for preventing hypoglycaemia?

The trial found smaller glucose declines and less time below 3.0 mmol/L after HIIE compared with continuous moderate exercise. However, that does not establish HIIT as universally safer for every person with type 1 diabetes.

Why does insulin on board matter during exercise?

Insulin promotes glucose uptake, while exercising muscles also consume more glucose. When substantial insulin remains active, these effects can combine and increase the likelihood of falling glucose.

Should people with type 1 diabetes exercise before eating?

Not necessarily. The best timing depends on insulin therapy, glucose trends, exercise type, fitness, and individual responses. Changes to insulin or exercise routines should be discussed with a diabetes care professional.

Can glucose fall hours after exercise?

Yes. Exercise can increase insulin sensitivity after a workout, so delayed and overnight hypoglycaemia may occur. CGM monitoring and an individualized management plan can help identify these patterns.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/exercise-timing-type-1-diabetes/ 

Type 1 Diabetes - 1 Step Ahead

From testfortype1.com

Think you know Type 1 Diabetes? We’re here to help you understand how it differs from Type 2 Diabetes, who may be at higher risk, how early detection can identify Type 1 Diabetes before symptoms appear, and the research trials currently screening thousands of adults and children across the UK. 

Overview

• Type 1 Diabetes is an autoimmune condition. This means the body’s immune system mistakenly attacks the insulin‑producing cells in the pancreas.
• Insulin is a hormone that helps move glucose from the blood into the body’s cells for energy.
• Over time, as more of these cells are lost, the body can no longer control blood sugar on its own, and insulin injections become necessary.
• T1D often develops slowly and quietly, with no obvious symptoms at first.
• Learning about the condition can help you and your family feel prepared and informed.

Key Facts About Type 1 Diabetes in the UK

• Around 464,000 people in the UK live with Type 1 Diabetes.
• It can develop at any age, but is more commonly diagnosed in childhood or early adulthood. Read who may be at greater risk of T1D
• T1D is an autoimmune condition and is not caused by lifestyle, diet, or personal choices .
• More than 1 in 4 children are diagnosed after developing diabetic ketoacidosis (DKA), a serious complication that needs urgent care. Know the symptoms and complications of T1D

How Does aT1D Develop?

1. Immune system activation

Normally, the immune system protects the body from infections. In T1D, it mistakenly identifies the insulin producing cells as harmful and begins to attack them.

2. Autoimmune progression

This autoimmune process may continue for months or years without symptoms.

3. Declining insulin production

As more insulin producing cells are lost, the pancreas produces less insulin. Blood glucose becomes harder to control naturally.

4. Symptoms emerge

When insulin levels fall too low, symptoms such as thirst, weight loss, tiredness, and needing the toilet more often can start to appear. These are commonly known as the '4Ts' Toilet, Thirsty, Tired, and Thinner.

5. Diagnosis & Lifelong Management

At diagnosis, individuals with T1D may require insulin therapy to maintain safe blood glucose levels and support normal metabolic function.

What Causes Autoimmune Type 1 Diabetes?

Genetic factors

The exact cause of T1D is not fully understood. Current evidence suggests a combination of genetic and environmental factors. Read more about the common misconceptions and myths in the diagnosis of diabetes. Some people inherit genes that increase their likelihood of developing autoimmune conditions, including T1D. However, having these genes does not mean the condition will definitely occur.

Environmental triggers

Environmental factors are believed to play a role in triggering this autoimmune response, although the exact causes are not fully understood. These include:

• Viral infections
• Changes in the gut microbiome, which may affect immune regulation
• Early‑life environmental exposures that influence immune system development
• Other unknown environmental factors

However, these factors are not direct causes of T1D. Importantly, type 1 diabetes is not caused by diet, lifestyle, weight, or personal behaviours, and it cannot be prevented through lifestyle changes.

Long‑Term Health Problems
Over many years, high blood sugar can affect different parts of the body, such as:

• the eyes
• the kidneys
• the heart
• the nerves

These problems do not happen straight away and do not affect everyone. With regular care, check‑ups, and support, many people with Type 1 Diabetes stay well and active.

Difference between Type 1 and Type 2 Diabetes?

Type 1 Diabetes happens when the body's immune system mistakenly attacks the cells that make insulin, it usually starts in childhood but can happen at any age. Type 2 Diabetes is much more common and occurs when the body struggles to use insulin properly, often due to factors like weight, diet, and physical activity levels. The biggest difference is that Type 1 can't be prevented or reversed, while Type 2 can often be managed and sometimes even improved through healthier lifestyle choices and medication.

Early Detection Could Help you Get Ahead of T1D

Early Detection of Type 1 Diabetes Can:

• Gives you and your family valuable knowledge and time. Being identified earlier could help give you more time to understand the condition and reducing the stress and anxiety of a sudden diagnosis.
• May help reduce severe illness at diagnosis. Research studies have shown lower rates of severe illness such as diabetic ketoacidosis (DKA) at diagnosis among children and adults identified through early‑detection research programmes.

How Does Early Detection Work?

• The main method used in research is autoantibody screening. Autoantibody screening is used to identify immune markers that appear before symptoms of Type 1 Diabetes develop.
• Autoantibodies are markers made by the immune system when it mistakenly targets the body’s own insulin‑producing cells. These markers reflect an autoimmune response and are central to understanding early‑stage Type 1 Diabetes.
• Finding certain combinations of autoantibodies can indicate a higher likelihood of developing T1D in the future. Research shows that the presence of multiple diabetes‑related autoantibodies is strongly associated with progression toward clinical Type 1 Diabetes.

Decision Aid: Should I Consider Early Detection?

Early Detection for T1D is currently available in the UK through research programmes and not part of routine NHS care or a screening programme. This short decision aid may help individuals consider whether Early Detection could be relevant to them:

You may wish to explore screening if any of the following apply:

• You have a parent, sibling or child with autoimmune T1D.
• You have a second‑degree relative (grandparent, aunt, uncle or cousin) with autoimmune T1D.
• You or a family member has another autoimmune condition (e.g., coeliac disease, autoimmune thyroid disease).
• You have been diagnosed with diabetes as an adult and would like to understand whether it may be autoimmune in nature.
• You have no family history but are interested in understanding your risk within a research setting.

Early Detection does not diagnose diabetes. It identifies autoantibodies that may indicate an autoimmune process. Participation in research programmes is voluntary and doesn't replace routine NHS care.

If you are concerned about diabetes or its symptoms, please speak to your healthcare professional.

https://www.testfortype1.com/uk/what-is-autoimmune-type-1-diabetes

Eating only 8 hours a day may help control Type 1 diabetes

From sciencedaily.com

Summary: Eating only between noon and 8 p.m. improved blood sugar control in a small study of adults with Type 1 diabetes and obesity, while avoiding an increase in serious complications. The promising findings offer the first evidence that time restricted eating could become another tool for managing the condition.

A new UIC study suggests that time-restricted eating could offer a safe and potentially effective way to improve blood sugar control in adults with Type 1 diabetes. The research was led by kinesiology and nutrition professor Krista Varady, a longtime researcher in the field of intermittent fasting.

"This is the first study to examine the effects of intermittent fasting on people with Type 1 diabetes, and the results are extremely promising," said Varady, a leading expert on intermittent fasting who conducted some of the first human studies on the subject.

Testing Intermittent Fasting in Type 1 Diabetes

Type 1 diabetes is a chronic condition in which the body produces little or no insulin, a hormone needed to move glucose from the bloodstream into cells. The condition affects less than 1% of people in the U.S.

For the study, Varady recruited adults with Type 1 diabetes who were also classified as obese according to the Centers for Disease Control and Prevention's body mass index. Varady said this combination applies to about 0.5% of the total U.S. population.

Researchers enrolled 32 participants from the Chicago area and randomly placed them into one of three groups for six months. One group followed a time-restricted eating schedule, consuming food only between noon and 8 p.m. without counting calories. Another group reduced calorie intake by 25%, while the control group made no changes to its usual behavior.

An 8 Hour Eating Window and Blood Sugar

After six months, the time-restricted eating group showed better blood sugar results than the calorie-reduction group. HbA1c, a blood test that reflects average blood sugar over the previous several months, fell by about 0.5% on average in the time-restricted group.

The researchers also found no increase in the risk of dangerously high or low blood sugar levels among participants following the restricted eating schedule. The approach likewise did not raise the risk of diabetic ketoacidosis, which occurs when the body does not have enough insulin and can become life-threatening.

"This is the first step to showing time-restricted eating could be a safe, potentially effective method for people with Type 1 diabetes to manage their blood sugar levels," Varady said.

Researchers Urge Caution

Although the early findings are encouraging, Varady emphasized that the study is only an initial step and should not be taken as a reason for people with Type 1 diabetes to change their eating habits without medical guidance.

"Of course, this is just the first step," she said. "Anyone making changes to their eating habits, especially those with diabetes, must work closely with their endocrinologist or healthcare provider to find a solution that works for them."

Varady next hopes to conduct larger studies across multiple research sites to determine whether the findings hold true in a broader population.

Other UIC authors on the study are Mary-Claire Runchey, Sarah Corapi, Vasiliki Pavlou, Sofia Cienfuegos, Shuhao Lin, Mark Ezpeleta, Kelsey Gabel, Lisa Tussing-Humphreys, Vanessa M. Oddo, Julienne Sanchez, Terry Unterman and Sirimon Reutrakul.

Varady is also an affiliate of the University of Illinois Cancer Center.

https://www.sciencedaily.com/releases/2026/09/260909231740.htm

Navigating Type 1 Diabetes Away From Home

From diatribe.org 

Janelle Tobias Sanderson shares her personal experiences and strategies for navigating college with type 1 diabetes

College is an exciting time when you grow into your identity and get to decide what type of person you want to be. As I enter my thirties and reflect on my university experience, there is plenty of advice on type 1 diabetes I wish I had embraced earlier in life. Entering college as a person living with type 1 can be challenging, but it is possible and manageable. 

When I started college in 2014, I showed up to my freshman dorm room with a purple Medtronic pump and blood glucose meter. For the first two years of undergrad, I did not have a continuous glucose monitor (CGM), so I typically checked my blood sugar in the morning and before bed. Unless I felt clearly off, I did not check that often. 

In high school I often hid my diabetes, but moving to a new city without my family nearby, I knew that I would have to make a greater effort to share this part of myself. I was nervous to tell my roommate, an initial stranger, about my chronic condition. However, she was very kind and quickly became a great friend who helped make sure we always had juice in the room. Even though I didn’t want to, I wore a medical bracelet, and while many of my friends knew I had diabetes, I never fully shared what that meant in terms of symptoms or how to help beyond having access to sugar.

I was diagnosed at 13, so my mom would go to every doctor’s appointment with me. I tried switching to an endocrinologist who was closer to my university, but finding an endo as an adult was my first experience going to the doctor alone. I didn’t know what questions to ask or how to advocate for myself. I struggled to find a local doctor with whom I connected, and because I loved my hometown provider, I ultimately scheduled my endocrinology appointments for when I came home in between quarters. This meant I went to the doctor every four months instead of every three months.

In my last endo appointment before starting school, my provider wanted to ‘prepare me’ for college and spoke to me about living with type 1 diabetes, drinking alcohol, and substance use. She told me to beware of overnight lows after drinking, and that if I did any drugs, it would eventually lead to amputation due to poor circulation. She was quite intense, and I left this conversation absolutely terrified. Her fear tactic worked for me, but I felt this burden at 17 that my decisions as a teen could deeply affect my quality of life years from now. 

In high school, I had structured days with consistent meals and movement, walking from class to class throughout the day. In college, you decide your own schedule, and I had no routine. I ate whenever it was convenient, rarely checked my sugar or gave correction boluses, and my sleeping schedule was terrible. It wouldn’t be until I went to my endo appointments, where my A1C would continue to rise, that I would learn my management was not ideal, and it felt like a personal failure. 

If you’re living with type 1 diabetes and going to college for the first time, here are some of the most valuable lessons I learned from my college experience.

Ask for help 

Managing type 1 diabetes is a full-time job. When you are also a full-time student and involved in extracurricular activities or working a part-time job, it can be easy to focus less on taking care of your health. I never asked for help, and I felt isolated. It is hard to be a productive student when your blood sugar is stuck high or crashing down. Help might look like asking a family member or close friend to follow you on your CGM app, or restocking your snack drawer so you always have easy access to carbs. I find that people are often willing to help if you are able to ask.

Finding community 

Most people you meet in college won’t know about diabetes unless they know someone living with it. I was very insecure about having type 1, and refused to join support groups or connect with others who had diabetes. This resistance made me suffer alone and made my diabetes feel like a burden that only I could carry. My friends from college, whom I am still close with today, are the ones I felt comfortable being open with about diabetes. In grad school, I even had a roommate who also had type 1, and it was amazing living with someone who truly understood my lived experience. 

Having a routine 

Not every day has to look the same, but having a general plan for regular meals and exercise can help make overall diabetes management less burdensome. When I eat meals at similar times, my blood sugar is more predictable and easier to manage. This is not always possible, and that’s ok, but having easy sugar (fruit snack packets are my go-to option) and protein bars available can help when you have a busy class schedule. 

Alcohol use 

It is possible to drink alcohol while having diabetes. However, be aware that alcohol can change your awareness or ability to manage your diabetes. Make sure to eat before drinking and have low snacks by your bed in case of night-time lows. If you choose to go to a party and drink, make sure you go with a trusted buddy who is aware that you have diabetes. 

Learn about health insurance early 

Even though I had access to a student health insurance plan, the coverage was not good, and I decided to stay on my parents’ insurance until I was 26. I have an incredible mother who handled all of the calls to the pharmacy and insurance on my behalf. It wasn’t until I was in grad school and finally on my own insurance that I realized I did not fully understand prior authorizations. It would have been helpful to learn more about the amount of paperwork and phone calls needed to re-order the supplies I relied on to survive. 

How diabetes tech can help

Towards the end of my second year, I finally got a CGM, the Dexcom G5. At the same time, I switched from Medtronic to Omnipod and fell in love with wearing a tubeless pump. Having the right diabetes technology that worked for me gave me a greater sense of independence and agency over my health. After undergrad, I went straight to graduate school and decided I wanted to live by myself. I used to think this was not safe, but empowered by a pump and CGM that worked for me, I found a studio and lived alone for two years. 

The bottom line

College is an exciting time where you get to meet new people, learn a lot, make mistakes, and grow as an individual. For many people with type 1, it is their first time taking care of their diabetes without their family’s daily support. 

Allow yourself some grace as you balance schoolwork with being your own pancreas, and ask for help if you need it. I spent my high school years resenting diabetes, and in college I grew to accept my diagnosis. All of the highs and lows helped me gain confidence in managing my type 1 independently.

https://diatribe.org/diabetes-management/navigating-type-1-diabetes-away-home