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Self-Reported Factors That Affect Glycemic Control in College Students With Type 1 Diabetes

Yale University School of Nursing

Jean M. Cantey-Kiser, PhD

New Haven, Connecticut; Data Coordinating Center, Boston University School of Public Health, Massachusetts

Craig A. Alter, MD

Division of Pediatric Endocrinology, Department of Pediatrics, UMass Memorial Health Care and University of Massachusetts Medical School, Worcester, Massachusetts

Stuart J. Brink, MD

Department of Pediatrics; New England Diabetes and Endocrinology Center

Shelley D. Yeager, MSW

Boston, Massachusetts; Clara Barton Diabetes Center, North Oxford, Massachusetts

William V. Tamborlane, MD

Department of Pediatric Endocrinology, Yale University School of Medicine

Stuart R. Chipkin, MD

Tufts University School of Medicine; Division of Endocrinology, Diabetes and Metabolism, Baystate Medical Center, 759 Chestnut Street, Room 2624, Springfield, MA 01199stuart.chipkin{at}bhs.org

PURPOSE

This study examined the self-reported impact of different factors on the overall diabetes care of college students with type 1 diabetes.

METHODS

An 18-item questionnaire was mailed to 164 students with type 1 diabetes attending college away from home; results from 42 students fulfilled study criteria and were analyzed. Metabolic control was assessed by relative changes in glycosylated hemoglobin (HbA₁c) levels from medical records.

RESULTS

HbA₁c levels did not change significantly between high school and college, yet most college students reported that diabetes was more difficult to manage in college. Commonly reported barriers to diabetes control included diet, irregular schedules, lack of parental involvement, peer pressure, drugs and alcohol, fear of hypoglycemia, and finances. Factors identified as improving diabetes control were an increased sense of responsibility, increased frequency of blood glucose testing, exercise, contact with healthcare providers, fear of hyperglycemia, and knowledge of the results of the Diabetes Control and Complications Trial. Many students reported testing their blood more frequently and taking more injections than in high school; most were on intensive insulin regimens.

CONCLUSIONS

Despite the perception that diabetes management was more difficult in college, metabolic control was maintained during college, possibly due to a more intensive treatment approach.

The Diabetes Educator, Vol. 26, No. 4, 656-666 (2000)
DOI: 10.1177/014572170002600413


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