At just 21 years old, recent Florida Atlantic University graduate Dylan Backer was rushed into the emergency room with a blood sugar of 738, over six times the normal level. For a few weeks leading up to the incident, he was struggling to keep food and water down, resulting in physical weakness and dehydration.

Doctors diagnosed him with Type 1 Diabetes (T1D).

Patricia Dittman, a nationally certified diabetes educator at FAU, says diabetes is a chronic disease that occurs when the body cannot produce low or high amounts of insulin. Insulin is a hormone in the pancreas that helps the body use or store glucose, or blood sugar, that it receives from food, the American Diabetes Association reports.

Type 2 Diabetes (T2D), as described by the National Institute of Diabetes and Digestive and Kidney Diseases, is considered the most common type of diabetes and occurs when the body’s blood sugar is too high, rather than too low. Dittman says this type of diabetes usually affects people over 40 years old.

T1D occurs when the pancreas produces little to no insulin, according to the Centers for Disease Control and Prevention. T1D usually appears in young people under 20 years old and is “very infrequent” compared to T2D, Dittman says.

“It’s a dramatic presentation to the emergency room where they feel terrible and their blood sugars are over 500,” Dittman said. “So, they usually go into what we call ‘diabetic ketoacidosis,’ and they usually are put in intensive care with an insulin drip, and they’re on insulin the rest of their lives. They have no other choice.”

This is exactly what Backer experienced.

“You know, I had turned 21 just two weeks prior. So, that was really a shock. And it’s been about a year now, and it still is a shock in a way, you know? Like, at times, it still doesn’t feel like it actually happened. It kind of feels like I’m living in a bad dream,” said Backer.

The National Library of Medicine conducted an online survey in 2020 with 697 students at West Virginia University. Researchers found that while diabetes is not so prevalent in college students, around 3.3% reported they had either T1D or T2D.

Both types are similar in that the body isn’t able to regulate blood glucose levels, causing either hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).

Most people diagnosed with diabetes use either an insulin pen or an insulin pump to regulate their blood sugar. An insulin pen is a needle diabetics inject into their skin when insulin levels are too low, while a pump is a medical device attached to the person at all times, supplying them with a continuous flow of insulin.

For diabetic students at FAU, college life looks a little bit different. While worrying about exams and deadlines, they also juggle blood sugar checks, insulin doses and meal planning — hoping to bring greater awareness to their disability.

Managing diabetes and school

Researchers noted in a 2023 study review that planning ahead for diabetes can be strenuous for students entering and navigating through college, as they have to manage not only the disability itself but the stigma from peers that comes with it.

“Students avoided disclosing their diabetes if they anticipated a negative reaction, such as rejection or discrimination, were made to feel different, explain diabetes or receive unsolicited advice,” the review reads. “… Students learnt to adapt their diabetes self‐care to the flexible university environment, which could involve long days and irregular schedules.”

To Backer, planning ahead can be exhausting. He always made sure to carry snacks high in sugar and keep insulin flowing through his Dexcom insulin pump, which kept him from passing out when walking to class. He found it especially hard to manage his diabetes on a hot day when exerting lots of physical energy.

“You know, from a physical standpoint, as long as I just keep it in range, then I’ll be fine,” said Backer. “But there are times where I’ve experienced loads, where my blood sugar goes too low because I might have taken too much insulin, or, you know, miscalculated something when I did my dosage. And those are scary.”

Michael McCourt, a senior accounting major at FAU, lives with the same diagnosis as Backer — though McCourt has had T1D since he was 12 years old. 

While he already had years of experience dealing with this chronic disease, he has encountered new challenges in college. McCourt says good sleep, exercise and eating habits may be difficult to maintain, but that balance is imperative to his health.

However, it can be difficult to manage even after taking all the right precautions. When a diabetic’s blood sugar is extremely high or low, they can experience symptoms that mimic intoxication, including blurred vision, dizziness, fatigue, slurred words and sweet breath that may smell of alcohol.

“Especially when your blood sugar is high, you can’t focus. It’s nearly impossible, you get this symptom of where your head becomes cloudy and you can’t really think as accurate or as critically as you may when you’re sober and your blood sugar is normal,” McCourt said. “Say, when you’re taking tests, you’re studying — yeah that’s really going to affect you.”

One time, the stress from a final exam caused McCourt’s blood sugar to rise – but issues with his insurance got in the way of quick treatment.

“I was really stressed because first, you got the final on one hand, that’s one problem,” said McCourt. “But now you got another problem, where you’re calling all the Walgreens trying to find out which one has insulin they can give you… if you don’t have insulin, you don’t live.”

What resources does FAU offer diabetic students?

FAU’s Student Accessibility Services (SAS) provides accommodations to students with diabetes depending on their academic barriers and personal experiences, according to university spokesperson Jonathan Fraysure.

Fraysure noted in an email to the University Press that SAS may allow diabetic students to use their cell phones during class and electronic medical devices in testing rooms. Students are also allowed extended time on exams, excused absences and breaks during class to access snacks and drinks.

McCourt says he was reluctant to take advantage of the university’s accommodations. He feels that oftentimes, there isn’t much anyone can do to help him, and speaking up requires a level of vulnerability he isn’t quite comfortable with.

“You have to go over to the professor and explain to them, ‘Hey, look, my blood sugar is 300; I’m not going to be sober while taking this test. Is there a chance I can take this test another time?’” McCourt said. “I feel like that would just be very difficult to explain to a professor and they might not be understanding, so I’ve never tried it.”

In Backer’s experience, however, he has never shied away from telling instructors about his diabetes, to which they have offered him help.

“At the end of the day, they just cared about my health,” Backer said. “They basically just said, ‘Do what you gotta do. I know it’s not going to be a distraction or anything like that. I know you’re a hardworking kid, so do what you’ve gotta do. And just stay healthy.’”

On and off-campus diabetes education resources

Dittman notes that there are clinics on every FAU campus. Each will provide students with information about diabetes. She also encourages students to schedule a meeting with her if they want to learn more about diabetes.

“We don’t have a lot of certified diabetes educators at FAU. I think I’m the only one,” Dittman said. “But even in the community, we don’t have a lot. So, that would be an area, I think, that we need to try and get more people to become nationally certified.”

In Palm Beach County alone, nearly 100,000 residents have diabetes and about 250,000 more are at risk, according to FAU/Northwest Community Health Alliance (NCHA) Community Health Center. Many local health organizations are putting together management programs to help combat the epidemic.

The Florida Department of Health in Palm Beach County (FLDH-PBC) offers a year-long Diabetes Prevention Program that aims to “decrease people’s risk of developing type 2 diabetes by 58%” through evidence-based lifestyle changes. 

Through an email request, the UP found that in 2024 thus far, a total of 68 people completed FLDH-PBC’s program, and a majority of workshop attendees were 44 years old or younger.

FAU/NCHA also offers classes that focus on lifestyle changes, treatment options, safe medication management, blood glucose monitoring and more.

In addition to classes, there are many local endocrinologists near FAU’s Boca Raton campus that provide blood tests, including Elite Diabetes and Endocrine Specialists and Princeton Medical Group. CVS Pharmacy provides diabetes tests seven days a week at its MinuteClinic in all locations.

The Diabetes Coalition of Palm Beach County also offers risk assessment screenings and educational initiatives in various parts of Palm Beach, and invites members of the community to volunteer. “Wherever the Coalition is needed, we go!” their website states.

Ultimately, to both Backer and McCourt, diabetes is something people have to manage on their own. They urge students with diabetes to listen to their bodies, stay prepared, find a support group and talk to doctors. 

However, they also emphasize the importance of being educated on how to properly help people with diabetes.

“A lot of people don’t even know what it is,” Mccourt said. “And then also, what are the symptoms of diabetes? If you see someone passed out or having a seizure, what are you supposed to do, and how can you help them? So I feel like this all kind of starts at the public health level, and I feel like the way to address it is through education.”

In the event of a diabetes emergency, Dittman says there are a few ways to help.

She encourages calling 911 immediately if the patient has already fainted. If the patient’s blood sugar is dropping but they are still conscious, she recommends taking them to a nearby clinic as soon as possible and giving them “some type of sugar source,” like soda or orange juice.

“That’s all they need to come right back,” Dittman said.

Sofia Mata contributed to reporting on this article.

Elisabeth Gaffney is the Editor-at-Large for the University Press. For more information on this article or others, you can reach Elisabeth at elisabethgaffreports@gmail.com or DM her on Instagram @elisabethgaff.