Young Adult & Type 1 Diabetes

Going to College
If you are heading to College we recommend that you have a look at the ‘Type 1 diabetes -Tips for college life’ booklet. You will find some practical advice on managing Type 1 diabetes for new 3rd level students. Click on the link to download –  Diabetes Tips For College Life or contact Diabetes Ireland and order a copy. It is also available at your college DARE office.

This booklet was written in 2013 as a guide for those with Type 1 diabetes, for themselves but also as a recourse for new friends, colleagues and room mates to help them understand more about Type 1 diabetes. It also includes tips on what to do in the event of a hypo and how illness can be managed.

Heading to college is daunting for most people. You may be excited, nervous, anxious and eager all rolled into one. It is a day you have planned for during the past year or two. You are now ready to embark on a new phase in your life and this usually involves spending a lot less time at home, or moving away from home for the first time.

Moving away from home
Until now home has probably more than likely been the natural hub of support for you as you grow towards adulthood. And family, siblings and friends at home will also have been a support for you when you are managing your diabetes.

With the move away from home comes more responsibilities. The structure of the day will be very different. You will be familiarising yourself with your new lifestyle over the first few weeks. The route to success is planning as much as possible.
Areas to look at may include:
• Timing of lectures
• Timing of meals, snacks and insulin
• Availability of meals and snacks
• Travel to and from college and mode of transport
• Looking after your own diabetes supplies
• Doing your own shopping
• Sports activities
• Leisure activities
• Socialising and alcohol

You may find that you are more active in college than at home with:
• Earlier mornings
• Running to lectures around campus
• Studying for long periods without eating
• Eating smaller meals
• Eating more convenience foods

All the above can keep all new students very busy, particularly if you are managing type 1 diabetes at the same time. This is why it is a good idea to build a support network of old and new friends to help you along the way. On campus health services may be a valuable source of support too.

Helpful links
DARE
www.accesscollege.ie/dare
The Disability Access Route to Education is a college and university admissions scheme which offers places on reduced CAO points basis to school leavers under 23 years old with disabilities(Type 1 diabetes as a lifelong condition qualifies under this definition)

Get AHEAD (The Association for Higher Education Access and Disability)
www.ahead.ie
They provide information about educational supports for students with disabilities, including diabetes. It says that students with any of the mentioned disabilities should check before the beginning of the academic year to find out what supports will be available to them.

It may be that your requirements are minimal such as being allowed to check glucose in the lecture hall or having a snack during an exam. AHEAD also make the point that “students must bear in mind that they will have to negotiate for the supports with the lecturers, tutors, or student support officers in the universities or the access officer in the IT colleges”.

Inform your college
College sources recommend that students with any particular health condition inform them at the start of the year. On a practical level this will ensure that the student knows the location of the college health centre, and from a clinical point of view, if there is a medical incident the unit staff will be aware of the student’s medical background. Students will also have access to a disability officer should the need arise.

Time for revision
It would be wise to take some time to revise your diabetes management plans, and observe what is happening with your diabetes over the first few weeks as you settle in. Revise the tips you have learnt regarding managing your diabetes if you are ill. Also take the opportunity to explain to friends and any new roommates what type 1 diabetes is, and what they would be able to do in the event of you having a hypo. Make sure that supplies to treat a hypo are available and that someone knows how to use glucagon, or to get help. You should carry some form of identification.

Activities and socialising
When you get involved in sports activities, take time to adjust your regime until you find what works best for you. You may decide to inform your coach and teammates of your diabetes, explaining the positive effects physical activity has on diabetes management. This means they can support you if you have a hypo. Parties and late nights will be a part of college life. If you drink alcohol, be responsible and take time to discuss with friends the effects of alcohol on your blood sugars.

Transition to adult services
We recommend having a look at www.steppingup.ie
Many teenagers with diabetes transfer to an adult diabetes service around this time. If you have not already moved, it may be a good idea to delay the move for a couple of months, if you can, until you are settled in. You can draw on the support from your adult diabetes team at this time, but you may be more at ease with speaking with the team you know well. At some stage you may decide to access a diabetes service closer to your college so that you can continue to attend your clinic appointments and reviews without traveling home. Otherwise you might be happy to schedule your appointments during college breaks.
According to an attendee at the Diabetes Ireland teen conference in Croke park Dublin 2009: “Care might become disjointed and young people can feel unsupported at this time” and “I do not feel you should move at this time because when starting college you might have no structure in your life”.

Don’t forget how your family has supported you and they can continue to do so from a distance. Don’t hesitate in keeping them up to date as to how you are coping in your new environment.

Career Choices
Many people find it difficult to make choices about further education and/or jobs. Let your interests and abilities be your primary guide. Like anyone else you can choose a job that fits your personal interests and abilities. Currently, in Ireland however exclusion, due to difficulty passing medicals because of taking insulin, still exists for those with Type 1 diabetes in the defense forces ,emergency services, railway workers and some careers at sea. In 2015, the Gardaí introduced individual assessment so this option is now open to people with diabetes to apply through the normal channels and conditions. For careers involving driving a HGV it may not be possible to retain the required driving license. For further information on HGV licenses please checkout our driving section.

Diabetes may be misunderstood and feared by some employers. If you are the right person for the job, it is important that you can show that diabetes will not affect your work.

At work
Always tell your colleagues you have diabetes and explain that it will have no impact on your performance when well controlled. Explain hypoglycaemia and what needs to be done in an emergency
Regular working hours make it easier to control your blood sugar. This does not mean that you cannot choose a job with irregular working hours or shift work but you will have to plan more carefully. When will you eat? When will you exercise? Will you be able to tailor your diabetes treatment to your working hours? You may have to test your blood sugar more often and increase the number of insulin injections you take each day. If you are working at a job with irregular hours, discuss your treatment plan with your diabetes care team.

Discrimination at work/education
Diabetes is not a disability. People who feel they have been discriminated against should consult Diabetes Ireland .
Diabetes Ireland is currently advocating the removal of blanket bans for these professions and advocating individual assessment based on ability.

Drinking alcohol
The general advice on alcohol consumption for a person with diabetes is the same as that for everyone. Alcohol should only be taken in moderation, to a maximum of 11 units per week for women and 17 units per week for men. The recent DOHC communications would state this as 11 and 17 standard drinks respectively. One should aim to have 3-4 alcohol free days per week.

There are some precautions a person with diabetes should take, if your diabetes is diet controlled;
• Choose ordinary varieties of beer or lager as opposed to the low sugar ones e.g. Satenbrau, Holsten Pils
• Avoid sweet drinks or liqueurs and use sugar free, diet or low calorie mixers
• Alternate an alcoholic drink with a low calorie mixer
• Remember that alcohol contains calories and these must be taken into account for overall food intake for the day
• If weight is a problem, then alcohol should be limited to special occasions.

For the person whose diabetes is treated with insulin or sulphonylureas please remember that extra care is required to prevent hypoglycaemia (low blood sugar). Your judgement may be affected when you drink and you may not recognise when blood glucose levels are low.
To reduce this risk:
• Keep to sensible drinking levels
• Do not drink on an empty stomach. Always have some carbohydrates like bread before you go out for an evening
• Eat little and often while when taking alcohol.
• Always carry identification and let your friends know that you have diabetes so that a low blood sugar is not mistaken for drunkenness
• Always carry glucose tablets or sweets
• Remember a hypo can happen some hours after a drinking session so test your blood sugar before going to bed
• Avoid low sugar beers/lagers as they are high in alcohol (Satenbrau, Holsten Pils )
• Use a spirit measure when at home
• Know your drinks and check the ABV (alcohol by volume) of your regular drink

Type of Drink                                       Alcohol Units  Calories
Beer/ale/cider (3.5%) Half-pint = 1 unit 90
Draught Stout Half-pint = 1 unit 100 100
Vintage Cider (6.0%) Half-pint = 1 ½ units 160
Spirits (Vodka, Gin, Bacardi, Whiskey) Spirits Measure = 1 ½ units 85
Dry Wine (12%) Small glass (110 mls) = 1 unit 70
Sweet Wine ( 12%) Small glass (110 mls) = 1 unit 90
¼ bottle wine (11 ½ %) Small bottle (187 mls)= 1 ½ units 150
Dry Sherry (16%) Small glass (50 mls) = 1 unit 55
Cream Sherry (16%) Small glass (50 mls) = 1 unit 70
Port Small glass (50 ml) = 1 unit 80
Alcopops (Smirnoff Ice) 1 bottle (275 mls) = 1 ½ units 145

If you are on insulin and going on a night out;
All of the above apply, but also remember:
• Have a snack before going to sleep
• Set the alarm clock for getting up in the morning and have someone reliable check that you are up
• Test your blood sugar frequently the day after a heavy session, as it is likely to fluctuate.

NB: It is illegal in Ireland for persons under the age of 18 to purchase or consume alcohol.

Travelling
Travelling with diabetes can appear to be a daunting experience but with some planning and preparation there is no reason why you can’t have a hassle free holiday of a lifetime. For more information on travelling with diabetes please head to our travel section.