Students at University with Type 1 diabetes – a management and lifestyle dilemma
There are estimated to be over 25,000 young people with Type 1 diabetes in Britain. These will typically go through several transitions from paediatric to adult diabetes services; from family support to independent living; from school to university or employment.
The results of a national survey of 1856 students with Type 1 diabetes came out in April 2018. This was conducted between June 2013 and June 2014 and, with nearly 600 completed responses, represented nearly one third of all UK university students with the condition.
The survey looked specifically at the impact of entering and attending university in terms of diabetes self-care and made for sombre reading:
- 62% maintained diabetes care with their home team and 32% had moved to their university provider.
- 63% reported finding their diabetes care harder to manage
- One third of the students questioned did not know their blood sugar levels. Of those who did 44% reported that their average blood glucose levels were higher than they had previously been.
- 52% reported frequent low blood sugar levels
- 28% reported that the number of missed insulin does had increased
- 6% reported severe low blood sugar episodes
- 26% had experienced diabetes related hospital admissions
- 12% had diabetes eye problems
Female students and those who had changed healthcare provider reported 200% more experiences of poor control of blood sugar levels, frequent episodes of severely low levels of blood sugar and emergency hospital admissions. Females were also more likely than males to report stress, low confidence, illness and issues with weight management.
Despite these difficulties 91% of students seldom if ever contacted the university support services about their diabetes
The student experience of diabetes management
Almost 30% had missed at least one clinic appointment mainly due to a clash with their university timetable but also because of being unable to travel home or from simply forgetting about it.
35% had not received at least one component of their annual diabetes review - the main component being the foot check. Fewer than half had seen a dietician, only 33% had seen a podiatrist and only 8% has seen a psychologist with over half the respondents reporting that they would not know how to access psychological help.
Of those who had moved their healthcare provider to the university 40% reported a reduced access to dieticians, 25% had problems in getting prescriptions during the holidays and 33% reported a lowered access to diabetic education. Despite this just over half rated their university clinic location as better and just under half indicated better access to specialist nurses and GP’s in the location of their university.
Nearly two thirds of those reporting found that it was slightly harder to manage their diabetes away from home citing in differing male/female proportions lack of parental involvement and challenges of the university lifestyle with erratic meals and routines and a lack of exercise.
Overall the findings of this research indicate that there is a need for a common national pathway for students with Type 1 diabetes who transition to university. This should not only upskill students in terms of self-management but should also focus on risky behaviour such as alcohol consumption, binge drinking and smoking. At the time of its publication the report’s authors were collaboratively working with Diabetes UK, JDRF and NHS England (diabetes) to establish those pathways
Meanwhile, for parents, it appears as if close support of their adult children to help them manage their Type 1 diabetes during this period may not be appreciated but will be hugely beneficial.
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