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Pandemic U: Back to College (Or Not) With Diabetes

As the school year approaches, college students with diabetes and their families are trying to figure out how to safely navigate returning to academics in the time of COVID-19

As a result of the COVID-19 pandemic, the back to school season is already looking different than any other, and college students and their parents are navigating it right now. Whether you’re a student who is returning to a changed campus, a scholar staying home for virtual classes, or the parent of a college child with diabetes facing tough decisions, there’s plenty of advice on how to handle college in the time of COVID-19.

Deciding what to do – whether to return to your college campus, take remote classes from home, or take a leave of absence from school – is going to be a difficult and individual decision for every student. While many students face this choice, many others do not, as their college is not allowing an option to return to campus (which can lead to additional difficulties and challenges). No matter what, the commitment to good health in this process is crucial.

“There’s a lot of fear around returning to school in the fall,” said Anna Floreen Sabino, the program director of the College Diabetes Network. While having diabetes doesn’t put someone at a greater risk for contracting COVID, the condition’s inherent blood glucose fluctuations and complexities can lead to more severe illness and outcomes from COVID infection. “We tell people that maintaining careful blood sugar management is something to be doing, regardless,” Sabino said. “It matters more than ever that you prevent diabetic ketoacidosis (DKA), handle sick days, and have supplies.”

Communication is key

It is recommended that you connect with the people and programs you or your child will need as early as possible. “If you have a roommate, be in constant contact with them, and reach out to the people on campus who are in charge of accommodations for classes,” said Emily Swanson, a 20-year-old nursing student at Carthage College in Wisconsin. While she won’t have a roommate in her dorm room this year, she will be sharing a bathroom with a friend. “Do what’s best for you and whatever makes you feel most comfortable and safe,” she said.

Swanson, who is an orientation leader for new students, the founder and president of the Carthage chapter of the College Diabetes Network, and the vice president of an honor society, chose to return to Carthage’s in-person classes this semester to maintain her place in its nursing program. If she had chosen to stay home, she would lose her spot in the program, and it could take a couple of years to return, she said. Her school is planning to reopen with precautions such as requiring masks and encouraging students, faculty, and staff to maintain social distancing. “I emailed one of my professors recently telling them I have diabetes and that while I’m healthy overall, I want to put my concerns out there. Her professor said the faculty are allowing people with health concerns to take classes remotely, but Swanson wants to take live classes because “I believe that nursing cannot be fully learned online. To be the best nurse I can be, I need hands-on experience in labs and clinical settings.”

For parents, “talk to your child about different scenarios and set a communication plan,” said Sabino. Review your plan for managing sick days and ensure your child has access to enough medical supplies. Make sure they have insulin, pens or syringes, pump supplies, blood glucose meter or continuous glucose monitor items, glucose strips, lancets, batteries for devices, glucagon, and fast-acting glucose to treat lows to prepare for any emergency. Sabino also advised parents to “help them where they need it; do as much logistical work as you can, such as calling offices before campus opens, to help have some of those bigger conversations.”

Things will be different

Some students may decide to stay home and continue school through remote learning, while some students may return to campus but will have to shift to virtual classes should COVID cases in the school rise. For those with diabetes, “You may not have some of the anxiety or self-advocacy challenges that are often present” during in-person learning, said Sabino. “You may not have to deal with interruptions, such as a device beeping or treating a low” during an in-person class or other college-based group settings. Reducing these visible and distracting moments could be seen as one of the few positives of the current state.

At the same time, “Nothing about the fall is cancelled, it will just look different,” said Sabino. Students who are used to eating meals in campus dining halls may be eating more take-out, and students may be living in single units instead of larger group residential spaces. While everyone is nervous about potential illness, “Everyone is also adapting and trying to incorporate as much of a college experience as possible,” Sabino said. “Classes will still happen, but they may look different. There may not be big sporting events with masses of students. Orientation may happen in a dorm room, not in a lounge. There may be events with individual servings of ice cream and not make-your-own sundaes.”

Parents are also giving their kids different advice this year. “I would say to my son or daughter, ‘Please, do not go to any parties,’” said Jodee Martin, the parent of a student with diabetes at Stanford University in California. Her son returned home in March and has attended his classes virtually ever since; Stanford has indicated that he will be able to return to campus for the winter and spring of his senior year. Martin said she would advise caution if he does return and would share the same advice to other parents of college students with diabetes: “Make sure anyone you are with in close proximity has been recently tested for COVID-19, do not wander the hallways, and restrict your contact with others,” she said. “If you have to be in a group meeting, wear your mask and stay six feet apart.”

Martin – who administers a Facebook page called T1D College Transition: A Forum for Parents – said parents should make a plan in case their kids get sick. “You have to prepare yourself for if you have to bring your child home or for you to get to where they are,” she said. “You’ll be advocating for them – even in a quarantined room or in a hospital setting. Chances are, they will need an advocate” to ensure their diabetes management isn’t put on the back-burner or ignored in favor of COVID treatment.

Adapt to the unknown

With constantly evolving coronavirus news and caseloads and statistics changing daily across the world, being flexible about schedules, classes, living arrangements and more will help you or your child cope more successfully throughout the semester – and possibly beyond.

Life during the pandemic is similar to living with diabetes, said Sabino. “As the semester goes on, students will need to be ready to make adjustments. That rings true for people with diabetes, who are used to the immediate tasks and interruptions needed to manage blood sugars. It makes the whole pandemic relatable.”

Find diaTribe’s other resources for coping with COVID-19 here. Click here for the College Diabetes Network’s ten tips for returning to school during COVID-19 for people with type 1 diabetes.