My Top 5 Concerns about Starting College with Type One Diabetes (and What I’m Doing about Them)

13 Mar My Top 5 Concerns about Starting College with Type One Diabetes (and What I’m Doing about Them)

Posted at 06:52h in Daily Life with T1D by The Helpful Type

Right now, I’m a senior in high school and finalizing my college decision. It’s an exciting time (but also a little surreal). In a few months, my life is going to look very different.

Starting college is thrilling. It’s also a little terrifying—especially when you’re bringing type one diabetes (T1D) along for the ride.

I’ll be living at home for at least the beginning of college, which removes one huge stressor (dorm life). But college still means more independence, new schedules, and eventually living on my own—possibly even studying abroad.

That’s a lot of change. And, as anyone with T1D knows, change can throw diabetes for a loop.

So, lately, I’ve been thinking about my biggest concerns about starting college with T1D, and now what I’m doing now to prepare.

1. Being Fully Responsible for My Diabetes

I’ve been managing my diabetes for years, but college is different. There’s no school nurse, no structured day, and no one reminding you to eat lunch.

Even though I’ll be living at home initially, college still means a lot more independence.

What I’m doing now:

Practicing taking full ownership of my supplies (keeping extras in my backpack, car, etc.)
Learning to troubleshoot pump or CGM issues without help
Getting comfortable making decisions about highs and lows quickly

Eventually, when I move out or study abroad, these habits will matter even more.

2. Unpredictable Schedules

High school schedules are pretty predictable. College schedules…not so much.

Classes might start at different times every day. Some might be three hours long. Meals might be later than I’m used to. Stress and sleep schedules will probably change, too. All of those things affect blood sugar.

What I’m doing now:

Practicing flexibility with meal timing
Paying attention to how stress and sleep affect my numbers
Keeping low snacks everywhere (backpack, car, desk)

Basically, I’m assuming my schedule will be chaotic and preparing for that.

3. Advocating for Accommodations

One thing many students with T1D don’t realize is that we can request accommodations in college.

That might include things like:

Being allowed to have food and drink during exams
Taking breaks to treat a low or high
Having access to diabetes technology (phones, CGMs, pumps) during tests
Extra or paused exam time if blood sugar issues occur

These accommodations are usually arranged through a university’s disability or accessibility office.

What I plan to do:

Contact the disability services office early
Work with my endocrinologist if documentation is needed
Communicate with professors at the beginning of the semester

Advocating for yourself is a skill, and college is definitely where you are honing it.

4. Emergencies When I’m on My Own

One thing I think about a lot is: What happens if I have a severe low when I’m by myself?

Right now, when I’m home, there are people nearby who know what to do. In college—especially when I eventually live on my own—that might not always be the case.

What I’m doing:

Making sure friends know the basics about T1D
Always carrying low supplies and glucagon
Sharing CGM data with trusted people (my parents)

It’s not about being scared—it’s about being prepared.

5. The Future: Living Independently (and Maybe Studying Abroad)

Even though I’ll start college while living at home, that won’t last forever.

Eventually, I’ll probably move into a dorm or apartment. I’d like for my moves and the changes to be incremental, and one of my biggest goals is to study abroad for a semester. That’s exciting, but also intimidating. Traveling with T1D requires extra planning: supplies, prescriptions, time zones, and healthcare access.

What I’m doing now:

Learning how to manage travel with diabetes
Keeping track of what supplies I use in a typical week
Getting comfortable explaining T1D to new people

The idea of the first time living alone being overseas feels overwhelming, so I’m hoping to build independence gradually before that happens.

The Truth about College with T1D

If you have T1D and you’re heading to college, it’s normal to feel nervous. But, thousands of students with T1D do this every year. Diabetes might make things more complicated, but it doesn’t make them impossible.

If anything, living with T1D teaches skills that college requires anyway: problem-solving, planning ahead, and resilience. And, honestly? We’ve already been practicing those for years.–Ellie