DRI College Guide

Table Of Contents:

Preparing For College Life With Type 1 Diabetes
Dorm & Roommate Prep
Managing Lows & Highs Independently
Campus Health & Accessibility Services
Alcohol & Social Life
Nutrition & Dining Hall Adjustments
Exercise & Bolusing for Protein
Managing Prescriptions & Insurance
Emergency Planning & Backup Supplies
DKA Prevention
Mental Health & Diabetes Burnout
Study Abroad & Travel Considerations
Advice from Students & Their Caregivers
If You’re Currently Attending College
One Last Thing

One of the biggest transitions in a person’s life is when they move out of their family home to pursue higher education. With acceptance letters hitting mailboxes and teenagers getting ready to graduate, the Young Leader Advocates came together to create an exhaustive guide to everything you need to know for living with type 1 in college.

Written by the Young Leader Advocates Group (YLA), a global community of students and young adults connected to type 1 diabetes through their own lives, their families, or their communities, who collaborate on peer education, advocacy, and support initiatives.

This guide was developed in close collaboration with Diabetes Research Institute (DRI) researchers and members of the broader diabetes care community, including caregivers and support networks, to ensure it reflects both lived experience and clinical best practices.

YLA members also worked directly with DRI scientists and clinicians throughout the process, asking questions, reviewing recommendations, and helping medically vet key sections of the guide. Through visits to the Institute, students toured the labs, saw technologies such as the Ricordi Chamber, viewed human pancreatic tissue used in research, and learned firsthand about the latest advances in treatment- and cure-focused science. Having this level of access while creating a student-led guide is something we consider incredibly rare and deeply meaningful (and honestly, pretty amazing 🙂).

What makes this guide different is that it was written by students who are living this transition right now, alongside caregivers and with direct input from researchers. It combines real-world experience with medical insight. Not just what should work in theory, but what actually does in dorms, dining halls, airports, classrooms, and late-night study sessions.

We’re sharing it now because this moment is both exciting and overwhelming. Many students are packing up, choosing classes, meeting roommates, and getting ready to leave home. And shortly after the excitement sets in, the same question often follows:

“But what about diabetes?”

This guide exists to answer that question honestly and practically. To help students feel prepared, families feel reassured, and everyone involved feel a little less alone heading into a big next chapter.

1. Preparing for College Life with Type 1 Diabetes

Contributor: Henry Jensen

Welcome! Whether you’re a teenager looking forward to living independently, a worried parent, an educator, or a school staff member, you’ll find below an extensive guide to campus life with type 1 diabetes. Compiled by members of DRIF’s Young Leader Advocates, in cooperation with DRI scientists and members of the DRIF Support Group and the T1D College Transition forum, it walks you through all of the steps for this big transition. Read on, and reach out with questions and comments, this is a living document that we hope grows and serves people for many years to come.

2. Dorm & Roommate Prep

Contributors: Henry Jensen, Kylie McDonald and Vivian Turner

As you move into your dorm, you may have a roommate or a room to yourself. If you do have a roommate, it’s important to let them know you live with type 1 diabetes and talk through what an emergency might look like and how they can help. It’s also okay to ask if they feel comfortable being part of that plan. Sharing a space with someone who is willing to learn what you might need can make a big difference, and it’s a reasonable request.

Before moving in

Create a prep sheet to give to your RA during move-in. This will give them a general overview of type 1 diabetes and outline what to do in an emergency.

“I gave a brief, detailed explanation on what type 1 is and how to handle high and low blood sugars in case of emergency.”
– Vivian Turner

If possible, exchange phone numbers between your RA and your parents.

“This calmed the nerves of my parents, knowing that there is someone who can easily be with me in case of an emergency.”
– Vivian Turner

Most importantly, explain how to use your glucagon (or preferred emergency method for lows). Place it in a specific spot in the room and let your RA and roommate know its location.
Share your CGM with your roommate and RA so they can receive emergency alerts. This can help reduce stress since others will be able to see your glucose levels.

Setting up an emergency plan

Communication is key. Your RA is also a student with their own schedule, so be upfront and ask them directly about what you need.

“I had to communicate with my RA about the use of needles and where I could dispose of them. My RA was able to help me and get me a red medical waste box, all because I asked!!”
– Kylie McDonald

Make sure your roommate is part of your support system. Let them know how they can help.
Create your emergency plan with your RA, and make sure your roommate knows about it as well.

“When my sugar was low in the middle of the night and I didn’t wake up, my roommate woke me up with a Coca-Cola bottle in hand! It’s these little things that truly help your transition from living with your parents to managing your diabetes on your own!”
– Kylie McDonald

3. Managing Lows & Highs Independently

Contributors: Chase DuPont, Henry Jensen, and Emmet O’Sullivan

Now, roommates and your RA are great, but managing your lows and highs independently is a necessary step in adult life. Here are some steps you can take to help make that transition easier on yourself:

Turn your ringer on so you can hear your alarms. If needed, sleep with headphones on.
Have a treatment method easily accessible, such as glucose tablets on your bedside table, juice, or other fast-acting sugars.
Eat a small amount of long-acting carbs, such as nuts or seeds, before bed to help stabilize your blood sugar.
Know your low and high symptoms and act early. Don’t wait.
Keep low snacks with you at all times.
Check your blood sugar regularly, even when you’re busy.
Set reminders if you tend to forget.
Let close friends or roommates know how they can help.
Always carry your essentials, even for short trips.
Be smart with alcohol and understand how it affects your blood sugar.
Stress, sickness, and late nights can mess with your numbers, so adjust as needed.

4. Campus Health & Accessibility Services

Contributors: Kylie McDonald and Sonia Morris

Your college campus should have accommodations available for students with disabilities, including type 1 diabetes. You can usually request these as soon as you commit to a school, so it’s important to get started early, before housing assignments and class schedules are finalized. Setting this up ahead of time can make day-to-day life on campus much easier and less stressful.

How to request accommodations:

Fill out your housing forms to request specific accommodations.
Some examples of accommodations are:
an extra refrigerator to store insulin
housing in close proximity to the cafeteria
housing in a room with no more than one roommate
housing with air conditioning
housing with a bathroom or sink attached
housing with access to a kitchen
early registration for classes
breaks during tests if blood sugar drops
access to the school gym
off-campus housing to facilitate meal preparation
a car on campus

5. Alcohol & Social Life

Contributors: Henry Jensen, Brody Sundheim, Mateo Blaschke, Maya Kotarski

Now that you’re in college, it’s pretty inevitable that you’ll be invited to a party at some point. It’s also realistic that you may drink at some point, too. That doesn’t make you reckless or irresponsible, it just makes you human. Having type 1 diabetes doesn’t mean you can’t be social or have fun, but it does mean you need to be more intentional about how you do it.

Alcohol affects blood sugar in ways that aren’t always obvious in the moment, and the decisions you make while drinking can impact you hours later. Be mindful of over-bolusing, drinking very sugary beverages, and overdrinking in general. Staying aware and pacing yourself isn’t about being boring; it’s about staying safe, feeling okay the next day, and taking care of yourself and your friends.

Why carb counting works differently when you’re drinking

Carb counting doesn’t work the same way when you’re drinking because:

Alcohol suppresses the liver’s ability to release glucose
This can cause delayed hypoglycemia, even if drinks contain carbs
Insulin needs may need adjusting
Monitoring, preventive measures, and emergency snacks (your friends might think this is funny) are essential

Research contributor: Aleida Saenz APRN CDCES, Diabetes Research Institute

Glucagon may not work properly during severe lows when alcohol is present because the liver prioritizes metabolizing alcohol over releasing glucose into the bloodstream.

How alcohol affects blood sugar

Alcohol (especially sugary drinks) can cause an initial spike in blood sugar
After several hours, blood sugar levels often drop
Symptoms of low blood sugar can look similar to being drunk (slurred speech, dizziness, confusion)

Managing diabetes at parties and late-night events

Eat carbs, protein, and fat before drinking to help stabilize blood sugar
Don’t drink on an empty stomach. This increases the risk of blood sugar spikes and lows
Keep sugary foods with you in case of lows
Check your blood sugar before, during, and after drinking
Avoid sugary drinks that can spike blood sugar and cause a crash later
Dry wine, light beer, or spirits mixed with diet soda are less likely to cause spikes than sugary drinks
Avoid sugary drinks like liqueurs (Jägermeister), flavored spirits, and pre-mixed cocktails. Heavy beers are higher in carbs and can spike blood sugar more than light beer
Tell a friend how they can help in case of lows or emergencies
Don’t drive home. Get a ride
Do not overdrink. It might be tempting, but staying coherent is the safest option

6. Nutrition & Dining Hall Adjustments

Contributors: Mateo Blaschke, Krish Hirani, Henry Jensen, Maya Kotarski, Vivian Turner

Navigating meal plans and carb counting on campus

Check nutrition information online, as most campus dining services list carb counts for meals
Find these guides before move-in if possible
Stick to consistent meals to help estimate carbs more accurately over time
Aim for regular meal times to make bolusing easier
Set reminders to check your blood sugar or bolus insulin around meals
Use apps like MyFitnessPal to log meals and estimate carbs or apps like Figwee for a visual estimation.
Meet with a campus dietitian if one is available
Stay mindful of foods that tend to negatively affect your blood sugar

Research contributor: Maddison Saalinger RD CDCES, Diabetes Research Institute

A simple plate method can help with carb estimation:

½ plate non-starchy vegetables
¼ plate starch
¼ plate protein

For reference:

⅓ cup cooked rice or pasta ≈ 15 g carbohydrates

7. Exercise & Bolusing for Protein

Contributors: Chase DuPont, Henry Jensen, and Maya Kotarski

Exercise and food can affect blood sugar just as much as what you eat, and sometimes in ways that feel unpredictable at first. Workouts can make you drop, spike, or do both, depending on the type of activity and how you adjust your insulin. Protein can also affect your blood sugar hours later, which catches many people off guard. Learning how your body responds to different workouts and higher-protein meals takes time, but having a few basic strategies can make exercising and eating feel a lot less stressful and more manageable.

Adjusting insulin for workouts

If you’re on a pump, consider having a basal preset specifically for exercise.
Eat before a workout. This could be a protein bar, a protein shake, or another form of long-lasting carbohydrates before you begin exercising. A banana is especially good for energy and maintaining glucose levels.
If you are doing intense cardio, such as sprinting, running long distances, or using the Stairmaster, lower your basal rate to reduce the risk of crashing during your workout.
In order to reduce the risk of hypoglycemia during the peak action of a pre-meal bolus, wait at least 2 hours after bolusing for a meal before a workout. Alternatively decrease the amount of bolus for the meal prior to the exercise. This applies whether on manual injections or an insulin pump.
If your pump has an exercise mode (like T-Slim, Mobi or Omnipod 5), consider turning that on.
Some research shows potential benefits of creatine in glucose metabolism
Anaerobic exercise, like weightlifting, can cause blood sugar to spike due to the release of adrenaline and other stress hormones such as epinephrine and glucagon. This varies by person, but if you notice this pattern, consider giving a small dose of insulin before working out.

Research contributors: Maddison Saalinger RD CDCES, Aleida Saenz APRN CDCES, Diabetes Research Institute

Bolusing for protein

Protein usually takes 3–4 hours to affect blood sugar. When carb intake is low, about 10–50% of protein can be converted to glucose through gluconeogenesis.
One way to bolus for protein, especially with packaged foods like protein bars, is to bolus for the listed carbs first, then bolus for the protein grams and extend that bolus over about 3 hours.
If you exercise after a high-protein meal, your insulin sensitivity can increase, and you may drop.

Managing delayed blood sugar spikes

One strategy to reduce or delay spikes is to eat the protein and vegetables on your plate first, then eat the carbs last. Protein digests more slowly, which can slow carb digestion and lead to a smaller or delayed spike.
Try pairing your complex carbohydrates with some protein and/or fat – for example pair your fruit with some plain greek yogurt, or crackers with some hummus.
Another strategy is to cool complex carbohydrates and then reheat them later. This can change how the carbs are digested and, for some people, may lead to a smaller or slower blood sugar spike than when eaten fresh.

Research contributor: Aleida Saenz APRN CDCES, Diabetes Research Institute

Aerobic exercise often lowers blood sugar, while high-intensity exercise may raise it. Wearing a CGM, carrying fast-acting glucose, avoiding workouts within two hours of a full meal bolus, and using pump exercise modes can help reduce risk.

8. Managing Prescriptions & Insurance

Contributors: Henry Jensen, Kylie McDonald, and Vivian Turner

Managing prescriptions and insurance might not be the most exciting part of college life, but it’s one of the most important. Running out of insulin or supplies is not something you want to deal with in the middle of classes, exams, or a new city. Having a system in place before you move in can save you a lot of stress later and help you stay focused on everything else college throws at you.

Keeping up with refills and pharmacy access

Have a plan or schedule for picking up your equipment and prescriptions
Time your pickups on your off-days so you actually have time to go to the pharmacy
Be aware of the transition from pediatric to adult care and plan ahead if your provider is changing

Prescription records

Keep a hard copy of your prescriptions
Write down every prescription you know you will take before heading to college
Keep a digital list in a drive (such as Google Drive) and bring a printed copy with you

9. Emergency Planning & Backup Supplies

Contributors: Henry Jensen and Vivian Turner

Even with the best planning, things happen. Packages get delayed, pharmacies run out of stock, pumps malfunction, and life gets busy. Having an emergency plan and backup supplies in place can make the difference between a stressful situation and a manageable one.

Many insurance companies offer an emergency school supply, usually covering up to 30 days of extra insulin and diabetes supplies. Ask your endocrinology team to place this order for you. These supplies can often be stored at your campus health or nurse’s office or brought with you to school in case of emergencies. If your insurance plan offers this, it’s worth setting up before you move in.

It’s also important to write down your pump settings (basal rates, insulin-to-carb ratios, and correction factors) and keep them in a safe place, both digitally and on paper. If your pump ever fails and you need to temporarily switch to injections while it’s being replaced, having this information ready will make that transition much easier.

10. DKA prevention

Research contributor: Aleida Saenz APRN CDCES, Diabetes Research Institute

To reduce the risk of DKA when living away from home:

Establish care with a local endocrinology team
Set up a local pharmacy
Always carry backup insulin (both short-acting and long-acting if you use a pump)
Keep ketone test strips available
Stay hydrated with fluids that contain sugar and fluids that do not
Seek emergency care if vomiting continues or ketones remain high
Do not stop insulin when sick without medical guidance
Keep regular medical appointments

Additional planning tips

Connect with other students on campus who also have type 1 diabetes, if possible. Having a support system of people who understand what you’re dealing with can make a big difference.
In an emergency, knowing other students who may have extra supplies and can lend you some can solve the situation much faster than waiting for a pharmacy or a shipment.
Keep track of your inventory and make a note when you have about two weeks’ worth of supplies left. Mail delays and pharmacy transfers can take longer than expected, and you don’t want to run out of insulin or equipment.
Consider wearing a medical alert bracelet or necklace that will “speak for you” when you can’t.

This section was shaped by input from our support community, including people living with type 1 diabetes, caregivers, healthcare professionals, and others in the broader care circle around diabetes. Many of them have already been through the college transition and shared what actually works in real life, what they wish they had packed, and what helped most during stressful moments.

The tips below focus on staying organized, planning ahead, and making sure you always have what you need, whether you’re living in a dorm or an apartment.

What to keep in a dorm or apartment

A designated storage area for diabetes supplies. Staying organized makes everything easier.
Always have a glucometer (manual), lancing device, and test strips in your apartment and with you when traveling to class. Having 3–4 meters is helpful in case one gets lost.
Keep a backup insulin pen in your dorm or apartment in case of pump failure.
Store backup insulin and CGM sensors in a safe, consistent place.

A mini fridge or dedicated refrigerator storage can help keep supplies protected and easy to find.

Know what to tell your RA about your diabetes and where your emergency supplies are located.
Keep a list of pump and CGM company phone numbers in case you need to order a replacement quickly.
Keep extra insulin prescriptions on file when possible.
Know how to request emergency prescription refills if you run out unexpectedly.
Take photos of sensor error codes or faulty DME to make customer service calls easier.
Look into Patient Assistance Programs (PAPs) if needed (note: these typically do not apply to Medicaid patients).

11. Mental Health & Diabetes Burnout

Contributors: Young Leader Advocates Group (YLA)

Diabetes is hard sometimes. College adds even more on top of that. Between classes, changes in sleep and social life, and the need to manage everything more independently, it’s normal to feel overwhelmed at times. It’s also normal to mess up occasionally. Diabetes isn’t something you “perfect,” and it’s definitely not a smooth, constant ride.

What matters most is not letting those moments become your norm. Small routines, like eating around the same times each day or checking in with yourself mentally, can help create stability when everything else feels unpredictable.

It also helps to talk about your diabetes. You don’t have to tell everyone, but letting a few people know can take a lot of pressure off. There are millions of people in the U.S. living with type 1, and most people are more understanding than you might expect. If something ever goes wrong, having people around who know what’s happening can make a real difference.

Stress can also affect your body in real ways, including increasing insulin resistance. College life often brings irregular sleep, inconsistent routines, alcohol use, diet changes, and shifts in exercise, all of which can impact your blood sugar and insulin needs.

Managing stress & burnout

It’s okay to make mistakes sometimes. Everyone does. Just try not to let it become your normal pattern.
Aim for some consistency when you can, especially with meal times and sleep.
Even small routines can help your blood sugars and your mental health.
Give yourself credit for what you are doing right. Managing diabetes every day takes effort, even when it doesn’t feel visible.

Talking to others about your diabetes

You don’t need to share with everyone, but telling roommates, close friends, or teammates can reduce stress and help you feel less alone.
If people know what’s going on, they can help in an emergency and understand if you need to step away to treat a low or check your blood sugar.
Being open can also help normalize diabetes for others who may not know much about it.

Insulin resistance in college

Chronic stress and lifestyle changes during college can increase the risk of insulin resistance for people with type 1 diabetes. Common factors include:

Irregular sleep
Inconsistent routines
Alcohol use
Diet changes
Changes in exercise
Ongoing mental stress

If you notice your insulin needs increasing, your blood sugars becoming harder to manage, or patterns changing, it doesn’t mean you’re doing something wrong. It often just means your body is responding to new stressors

Managing insulin resistance

Focus on building a basic routine where you can, especially around meals and sleep.
Pay attention to patterns in your blood sugar and adjust with your care team if needed.
Try to manage stress proactively through movement, rest, talking to someone, or taking breaks when you need them.
Don’t hesitate to reach out to your endocrinologist or diabetes educator if things start feeling off.

Finding mental health support on campus

Every university offers some form of mental health support. This may include:

Counseling or therapy
Short-term mental health consultations
Stress management resources
Crisis support

Check your university’s website or student health portal for mental health services and a phone number to make an appointment. Getting support is not a weakness. It’s part of taking care of yourself.

12. Study Abroad & Travel Considerations

Contributors: Maya Kotarski, Emmet O’Sullivan, and Brody Sundheim

Traveling, especially internationally, is an incredible opportunity, but it does require extra planning when you have type 1 diabetes. This section was built with input from caregivers in Facebook support groups, as well as advice from Brody and Emmet, who have experience preparing for longer trips and international travel with diabetes. The goal is not to make travel feel intimidating, but to help you feel confident, prepared, and able to focus on the experience rather than worry about your supplies or safety.

Before you go

Learn how to say “I have diabetes” and “I need sugar/insulin/help” in the language of the country you’re visiting.
Research how diabetes care works in your destination country.
Make sure your destination has access to the type of insulin and supplies you use.
Talk to your endocrinologist about time zone changes and possible insulin adjustments.
Ask your doctor for a travel letter stating your need for insulin, syringes, pens, pumps, CGMs, and glucagon. This can help with airport security and customs.
Keep hard copies of your prescriptions and important medical documents.
Translate important medical information into the local language if possible.
Let your airline know in advance that you’re traveling with diabetes supplies if you’d like extra support.

Packing your diabetes travel kit

Create a dedicated travel diabetes kit that includes:

Extra insulin (more than you think you’ll need)
Pump supplies and/or insulin pens as backup
CGM sensors and transmitters
Test strips and multiple meters
Glucagon
Prescriptions (hard copy + digital copy)
Doctor’s travel letter
Medical ID
Copies of insurance and emergency contacts

Always carry diabetes supplies in your carry-on, never in checked luggage.

Airport & flight tips

TSA allows medical liquids like insulin over 3.4 oz, but you must declare them at security.
You are allowed to bring a separate medical bag.
Keep supplies easily accessible during flights in case of delays.

While you’re abroad

Store insulin properly (refrigeration when needed, avoid heat exposure).
Know where the nearest hospital or clinic is at all times.
Be prepared for differences in food and carb-counting changes.
Jet lag and schedule changes can affect blood sugar, so monitor trends closely.
Wear a medical ID, especially in unfamiliar places.
Let travel buddies know what to do if you have a low or emergency.

Research contributor: Aleida Saenz APRN CDCES, Diabetes Research Institute

Insulin can be safely stored during long flights using cooling cases such as Frio packs. Avoid freezing temperatures and prolonged heat above 85°F (29°C).

If you need insulin abroad, meet with a local endocrinologist or pharmacist to confirm the insulin name and concentration before dosing, as brand names and strengths may differ by country.

13. Advice from Students & Their Caregivers

Contributors: Vivian Turner and Kylie McDonald

Advice for daily college life

Build a class schedule that actually works for you, not just what looks good on paper. Many students find that having 1–2 hour breaks between classes helps. It gives you time to eat, snack, check your blood sugar if needed, and recover if you’re not feeling well before heading to the next class. Feeling physically better often makes it easier to focus and retain information.
Talk to your professors at the beginning of the semester. Explain your accommodations and give them a basic understanding of type 1 diabetes. Many professors are very understanding about things like leaving class early, missing class for medical reasons, eating during class, or needing deadline flexibility, but it helps a lot if they know ahead of time. It shows that you’re proactive and responsible.
Talk to your parents, caregivers, RAs, and other students. Ask what worked for them, what didn’t, and what they wish they had known earlier.

Unexpected challenges & how to prepare

Increased physical activity can be a surprise. Walking across campus every day adds up quickly, and many students experience more frequent lows at first as their bodies adjust.
Always carry glucose tabs or a fast-acting snack with you, especially during your first few months on campus.
When possible, schedule classes with building locations in mind. Running across campus to make it to class can trigger unexpected lows.

14. If You’re Currently Attending College

Contributors: Vivian Turner and Kylie McDonald

What to check with your school

Ask your school or student health office about:

504 Plans or accessibility services
Emergency protocols for students with medical conditions
Health center policies or accommodations for diabetes

Documentation for accommodations

Most universities require documentation from your doctor for any academic or housing accommodations. This usually includes:

Your diagnosis
Specific symptoms and how they affect academic functioning
Medical history and type/length of treatment
The accommodations being requested
The medical reasoning for those accommodations
Your healthcare provider’s signature and license number

Housing accommodations must also be requested by your school’s residence life deadline.

Many schools will not approve accommodations without detailed documentation from a healthcare provider, so it’s important to start this process early.

15. One last thing

Contributor: Henry Jensen

If you’re feeling slightly overwhelmed, that’s normal. College is a big step, and managing type 1 on top of it is no small thing. But you’ve got this. And more importantly, you’re not doing it alone. We’ve got you.

Pro tip: consider printing this guide out or sending it to your parent or caregiver before you leave. It will probably calm them down more than any text message ever could. It also shows them that you’re taking this seriously, that you’re prepared, and that you know how to handle things, while still letting them know you’ll reach out if you need support.

You don’t have to be perfect. You just have to be prepared enough to keep going, adjust when things get messy, and ask for help when you need it.

Stay connected

If you have questions that weren’t covered in this guide, ideas for future sections, or topics you’d like to see explored, we’d love to hear from you.

You can reach out to:

The YLA team [email link]
The DRI

You can also learn more about visiting the Institute, connecting with researchers, or scheduling a tour.