5 Things to Know When Leaving the Nest
1. Find a Doctor
Moving out on your own is a big deal, but with a little preparation you can be ready for anything, including managing diabetes as an adult. Most pediatric endocrinology practices start transitioning young people to manage diabetes on their own over the year or two before they are old enough for adult care. This includes lessons on how to find, maintain, and pay for health care. Your insurance will influence your choice of doctor, so search your insurer’s website for in-network providers in the area you’ll be living. Bring a list of them to your current diabetes care team. Chances are, they can recommend someone on that list. If your pediatric and adult health care teams are part of the same medical center, a provider from each may be willing to take part in a joint appointment to ensure everyone’s up to speed, says Kathy O’Malley, RN, BSN, CDE, clinical nurse manager at the University of Nebraska Medical Center’s Pediatric Endocrinology/Diabetes Division.
2. Get Smart About Food and Drink
Turn to your diabetes care team for recipes and tips on how to read food labels. “Nutrition is very individual, and working one-on-one with a registered dietitian/certified diabetes educator is most important to help build esteem [and] knowledge,” says Lisa Ameer, MS, RD, CDE, a dietitian with Rady Children’s Hospital in San Diego. If you’re heading to college, check in with the school’s registered dietitian, who can help navigate on-campus dining options. Ask if your school has an app that’ll help you choose diabetes-friendly foods in the dining halls. General food-logging apps, such as MyFitnessPal, can also be helpful.
Thinking about drinking? Because it hampers the liver’s ability to produce glucose, alcohol can cause low blood glucose (hypoglycemia). To avoid going low, alternate between booze and water, and snack while sipping. Carry fast-acting glucose and stay with a buddy who knows what to do if you have a serious low. “And set an alarm every two hours to remind yourself to test your blood sugar,” Ameer says.
3. Prioritize Your Health
If your parents have private insurance, you may stay on their plan until you’re 26. But if they don’t have private insurance, or if you were a Medicaid or Children’s Health Insurance Program (CHIP) recipient as a child, you probably need to get your own insurance starting at 19, though the age varies by state.
Diabetes is expensive. It helps to shop among the plans that your or your parent’s employer offers and within your state insurance marketplace. HMO plans are less expensive up front, but you’ll pay more for co-pays and be limited to network providers. PPO plans are more expensive, but they often have a lower deductible and cover more of the cost of out-of-network doctors. Your plan will also dictate which medications, including insulin, will be fully or partially covered, and which ones you’ll have to pay for out of pocket. If your meds are too expensive even with insurance, talk to a certified diabetes educator (CDE). “Often a CDE will have access to specialized cost-saving options and offers from each diabetes supply company,” says Marisa Fisher, MD, a pediatric endocrinologist at Children’s Hospital and Medical Center in Omaha, Nebraska. A diabetes educator can also help you work with a local pharmacist or other diabetes supply distributor to save money on test strips, syringes, and pump supplies.
4. Make Work a Safe Space
Legally, you aren’t required to tell your employer that you have diabetes. But consider telling someone, even if it’s just a coworker who promises to be discreet. Explain what to do in case of a diabetes-related emergency, such as how to administer glucagon if you are unconscious. Looping in your boss and human resources department can protect you if you face discrimination. If they know you have diabetes, they are obligated by law to offer you accommodations, such as allowing you to carry supplies, leave a meeting to take care of your diabetes, or eat at certain times or at your workstation. The American Diabetes Association (ADA) can assist if you are discriminated against on the job. Call 800-DIABETES (800-342-2383) for help.
5. Seek Support
When you’re moving somewhere new, you don’t have to say goodbye to support. Online support groups can connect you with people with diabetes around the world. If you’re headed to school, check out the College Diabetes Network, a peer support group.
The people you date can be part of your support system, too. You can even bring them to an appointment with a diabetes educator. “I typically meet with the significant other if it is a serious relationship just to give them a Diabetes 101 [overview] and answer any questions they may have,” says Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE, diabetes education manager and teen transition program coordinator at the University of Chicago Kovler Diabetes Center.