CDN REACH™ offers guidance for supporting students with type 1 diabetes and other chronic diseases

The College Diabetes Network (CDN) has launched a new initiative to reduce the significant physical and mental health risks facing college students with type 1 diabetes (T1D). CDN REACH™ (Reduce risk through Education, Advocacy and Collaboration in Higher Education) will share information and resources to help campus professionals protect the safety, health, and productivity of all students with diabetes on their campus.

With the CDN REACH initiative, CDN leverages almost 10 years of grassroots work on college campuses across the country as the only national non-profit that provides peer support and resources to college students with T1D. To date, CDN’s work has been focused on providing those students with the guidance they need to successfully manage the challenging transition to independence at college.

Christina Roth, the Chief Executive Officer and Founder of CDN, says that CDN REACH will now help campus professionals address the persistent barriers students with T1D face in reducing their mental and physical health risks. According to Roth, this starts with education and awareness about T1D as well as other chronic and invisible diseases.

“We’ve found that the biggest barrier to supporting these students is a misunderstanding around the prevalence of diabetes, the prevalence of chronic and invisible diseases, and an understanding of what that entails,” she said.
Roth says this means taking into account the unique emotional and behavioral needs of these students who are not only managing their diseases but advocating for themselves while away from home. Young adults with diabetes make life or death medical decisions daily and managing these decisions while navigating campus life and academics can be overwhelming and lead to depression, anxiety and isolation. In a 2017 survey conducted by CDN, fifty-seven percent of young adults with T1D reported an increase in depression since starting college.

CDN REACH is a multi-year initiative that was created out of conversations with college students about these barriers and issues. “We are a grassroots organic organization,” said Roth. “So all of our focus is on creating a community of young adults and identifying what barriers they’re facing to their care and their health. And one of the first that we identified was this constant need for self-advocacy on campus because of so much misunderstanding from faculty, administration, and even the disability services office.”

At the end of 2016, CDN started working to create educational resources for departments on campus to help them understand diabetes, and in 2018, CDN started piloting those resources at 22 campuses across the U.S.
Working with administrators is new territory for CDN. As the organization has grown, they have been able to establish relationships with decision-making bodies.

“We’re marrying our bottom up approach with this new top down approach,” Roth said. “So that we’re not only focused on the individual with diabetes, but now we’re able to work with administrators to make sure that they are better equipped to support any individuals that come through their institution.”

To have an impact at scale, Roth says, CDN needs to document why campus administrators should care about supporting students with diabetes, and why the lack of knowledge around it is a liability for them. Publishing resources is one part of the CDN REACH awareness campaign.

For the CDN REACH launch, CDN is publishing three educational resources developed for campus professionals: Guides for Student Health Services, Student Disability Services and Student Counseling Services. The guides include basic information on diabetes and diabetes care, each stakeholder’s responsibility under the American Disabilities Act, how to talk about diabetes, and information specific to the office’s interactions with students with diabetes.

Another early goal of the initiative is to create consensus around some of the gaps in understanding and care and create policy standards for caring for students with diabetes on campus. CDN REACH will provide expert clarification around topics of confusion that are causing conflicts on campus between students and their families and the college faculty and staff.

As an example, Roth points to a reluctance on the part of colleges to set a policy about intervention in the case of a severe hypoglycemic event or seizure. Where campus administrators have traditionally been concerned about the legal implications of intervening in these cases, CDN hopes to educate campus members about new therapeutic options that have made intervention much easier and safe.

Another issue for students is the restriction on the use of smartphones during classes or exams—smartphones that store data from a continuous glucose monitor, or the system that tracks their blood sugar in real time. CDN hopes to convey the sincere need that students have access to their blood sugar data housed on their phones and clarify what a standard should look like. Roth believes that with increased awareness of these issues, campus stakeholders will be motivated to address them.

The last pillar of the CDN REACH initiative is a multi-sector coalition comprised of leading diabetes and higher education organizations, with the goal of harnessing the expertise of thought leaders in both the diabetes and higher education spaces. The coalition will develop resources for campus professionals, communicate best practice guidelines and standard protocols and collaborate on university-specific initiatives and programs. The Mary Christie Foundation is joining in the effort as a Coalition Partners, alongside American Diabetes Association (ADA), American College Health Association (ACHA), Student Affairs Administrators in Higher Education (NASPA), among others.

Roth says that CDN has drawn lessons from campus mental health activism over the past decade, and with CDN REACH, is hoping to use the framework of awareness and advocacy to push for better outcomes. The improvements in how mental health is addressed on college campuses has laid the groundwork for chronic disease advocacy, in part due to the high prevalence of comorbid conditions like depression, anxiety and eating disorders among students with T1D. As administrators have come to a better understanding of how to address mental health, CDN sees an opening to connect that to chronic illness, and the subset of individuals who are at high risk.

Additionally, Roth believes that the CDN REACH initiative can set a precedent and provide valuable framework for addressing the needs of students with other chronic and invisible diseases.

“Chronic disease as a whole is misunderstood within higher education, the work CDN is doing in diabetes creates a template and a framework which can be applied far beyond type one diabetes into conditions such as type two diabetes, colitis, crohn’s, or other such conditions.”