Self-reported factors that affect glycemic control in college students with type 1 diabetes.
This study examined the self-reported impact of different factors on the overall diabetes care of college students with type 1 diabetes.



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.



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.



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.
Ramchandani
N
N
Yale University School of Nursing, New Haven, Connecticut (Ms Ramchandani)
Cantey-Kiser
J M
JM
The Data Coor­dinating Center, Boston University School of Public Health, Massachusetts (Dr Cantey-Kiser)
Alter
C A
CA
The Division of Pediatric Endocrinology, Department of Pediatrics, UMass Memorial Health Care and Uni­versity of Massachusetts Medical School, Worcester, Massachusetts (Dr Alter)
Brink
S J
SJ
The Department of Pediatrics, Boston, Massachusetts (Dr Brink)|New England Diabetes and Endocrinology Center, Boston, Massachusetts (Dr Brink)
Yeager
S D
SD
The Clara Barton Diabetes Center, North Oxford, Massachusetts (Ms Yeager)
Tamborlane
W V
WV
The Department  of Pediatric Endocrinology, Yale Univer­sity School of Medicine, New Haven, Connecticut (Dr Tamborlane)
Chipkin
S R
SR
The Division of Endocrinol­ogy, Diabetes and Metabolism, Baystate Medical Center, Springfield, Massachu­setts (Dr Chipkin)
D000328:Adult; D001294:Attitude to Health; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000517:prevention & control*; D003927:Diet, Diabetic; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D010379:Peer Group; D012307:Risk Factors; D012648:Self Care / Q000379:methods* / Q000523:psychology*; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities
D006442:Glycated Hemoglobin