The Transition to College for Adolescents with Type 1 Diabetes

The transition to college leads to changes in relationships with family and friends, alters health behaviors, and may impact psychological well‐being. Adolescents often move away from home, eat less nutritious meals, drink alcohol, and face stress from schoolwork and changes in relationships and living situations. These changes can be particularly problematic for adolescents with diabetes as they could affect how they take care of their disease and, subsequently, their metabolic control. The goals of this study were to determine if there are differences in relationships and health behaviors between freshman college students with and without diabetes; determine whether self‐care behaviors and metabolic control change from senior year of high school to freshman year of college for those with diabetes; and examine whether we could predict changes in metabolic control and self‐care behaviors with psychosocial variables. Participants were 29 adolescents with diabetes and 20 adolescents without diabetes. They completed an online survey and three 24‐hour dietary and activity phone recall interviews during senior year of high school and freshman year of college. Adolescents with diabetes reported worse sleep, more alcohol abuse, and consumed fewer calories than those without diabetes. Adolescents with diabetes also reported being closer and having more contact with parents than those without diabetes. There were no group differences in psychological well‐being. There were negative changes in metabolic control and self‐care behaviors for those with diabetes. Better sleep quality, more binge drinking, more smoking, and worse self‐care behaviors predicted the decline in metabolic control. Negative psychological well‐being and greater parent support predicted more better self‐care behaviors. These results suggest that the transition to college is very similar for adolescents with and without diabetes, but that increased education about alcohol and smoking and the importance of continued parental support could improve diabetes outcomes for those entering college.