Transition to university challenging for students with type 1 diabetes
medwireNews: Students with type 1 diabetes report increased difficulties with managing their condition when they start at university, with consequences for glycemic control and acute complications.
The findings emerge from the survey responses of 584 students with type 1 diabetes (31% of those contacted) attending UK universities. Of these, 63% felt that managing their diabetes was slightly or much harder at university than it had been at home.
Almost a third (32%) of students switched to their university’s healthcare team, resulting in mixed experiences. Forty percent said they had reduced access to dieticians and 33% to diabetes education, compared with their experiences at home, and 35% had problems getting prescriptions during the holidays. By contrast, 53% felt their university provider represented an improvement, with nearly as many reporting improved access to specialist doctors and nurses.
University itself created problems; of the 30% of students who had missed at least one clinic appointment during the preceding 12 months, 33% blamed a clash with their university timetable. Indeed, timetables were one of the main things that students felt prevented them effectively managing their diabetes at university, along with stress, irregular meals, the type of food and drink consumed, and the lack of structure and routine.
The average glycated hemoglobin (HbA1c) level was 68 mmol/mol (8.4%) among the two-thirds of students who were able to provide this information, and 44% said their HbA1c level had deteriorated since starting university, although 22% said it had improved.
Fifty-two percent of students said they had three or more episodes of hypoglycemia per week, and 9.6% had experienced severe hypoglycemia for which they required third-party assistance. Furthermore, 26% had been hospitalized for diabetic ketoacidosis and 10% for other diabetes-related reasons.
These complications were significantly more frequent in women than men, and in students who changed to a different healthcare team while at university, Khin Swe Myint (Norfolk and Norwich University Hospitals NHS Foundation Trust, UK) and co-researchers report in Diabetic Medicine.
Access to information and support was also an issue; for example, 50% of students did not know how to access specialist care while at university and around 45% lacked adequate support for managing insulin in the context of a changing routine.
“We recommend developing a common national pathway for young people with diabetes who transition to universities,” the team concludes.
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