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starting college with a chronic condition: tips for a healthy start

Teen talks with specialist and parent about mental health resources

Starting college is a big transition! New classes, potentially a new place to live and a lot more independence! If you’re managing a chronic condition like diabetes, epilepsy, a gastrointestinal (GI) disorder or a mental health condition, you might also be wondering how you’ll stay on top of your health while being away from home.  

The good news is that a little planning can help you feel more prepared and confident before move-in day. 

start planning before classes start

A few months before college starts, make a checklist of your health needs. Having a plan in place can help reduce stress once classes begin. Make a simple checklist that includes: 

  • Medications and prescriptions  
  • Doctor appointments  
  • Medical supplies  
  • Insurance coverage  
  • Emergency contacts  
  • School accommodations  

make sure you can get your prescriptions filled

One of the most important steps is figuring out how you’ll get your medications while at school. 

Before leaving for college: 

  • Ask your doctor for enough refills to last through the semester if possible  
  • Set reminders so you don’t run out of medication 
  • Find a pharmacy near campus and learn how to transfer prescriptions if needed 
  • Check if your insurance works in your college town  

This is especially important for students managing conditions like: 

  • Diabetes that requires insulin or glucose monitoring supplies  
  • Epilepsy medications that need to be taken consistently  
  • GI conditions that require daily medications  
  • Mental health medications that should not be stopped suddenly  

If you use specialty medications, ask your care team how deliveries will work at school.

know where to go for medical care

Before classes start, learn about the healthcare options near campus. 

Find out: 

  • Where the student health center is located  
  • Which urgent care or emergency room is closest  
  • Whether there are pediatric or adult specialists nearby  

Some students may continue seeing their pediatric specialist during college breaks or through virtual visits. Others may need help transitioning to an adult care provider closer to campus. 

Talk with your specialist before college about: 

  • How often you need follow-up visits  
  • What symptoms mean it’s time to schedule an appointment  
  • What to do if you have a flare-up or emergency 

take charge of your health

College is often the first time students manage healthcare on their own. Practice skills like: 

  • Scheduling appointments  
  • Calling in prescription refills  
  • Tracking symptoms  
  • Understanding your medications  

Keeping important medical information in your phone can also help in an emergency. Include your diagnosis, medications, allergies and emergency contacts. 

teen girl hydrates after playing soccer

don’t ignore mental health

Changes in sleep, routines and stress can affect both physical and mental health. If you already manage anxiety, depression or another mental health condition, stick to your treatment plan and know how to access counseling services on campus. 

Even students without a diagnosed mental health condition may struggle during the transition to college. Reaching out for support early can make a big difference. 

build healthy habits

Healthy routines can help you manage symptoms and feel your best. Try to: 

  • Get enough sleep  
  • Eat regular meals  
  • Stay hydrated  
  • Use reminders for medications and appointments  

Students with chronic conditions may also qualify for accommodations through their college’s disability services office. This could include things like flexible attendance or housing needs. Ask your doctor about any paperwork you may need before school starts. 

you don’t have to figure it out alone

Starting college with a chronic condition may take extra preparation, but you don’t have to figure it out alone. Consider talking with your roommate and close friends about your health needs. Many chronic conditions are “invisible,” so others may not know when you need help unless you share it with them. Letting someone know what to watch for and how to help in an emergency can help you feel safer and more supported on campus.  

Starting college can feel overwhelming, especially with a chronic condition, but support is available. Your healthcare team, family and school resources are there to support you along the way. 

With preparation and the right support, you can spend less time worrying about your condition and more time enjoying your college experience. 

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bad night’s sleep? how sleep impacts blood sugar in patients with diabetes

young child sleeping heavily

Did you know that diabetes can impact sleep? Or that poor sleep can affect blood sugar levels in patients with diabetes? Understanding the links between diabetes and sleep is one way you can support your child and help them feel their best!

sleep and unstable blood sugar levels

Children with blood sugar levels that are too high or too low may have a hard time sleeping through the night. Unstable blood sugar levels trigger other changes in the body that can cause your child to wake up.

If blood sugars are low, the body releases adrenaline. This causes an increased heart rate, sweating and possibly panic. These symptoms will usually awake the child from their sleep.

Sometimes, children will wake up because of a nightmare, but are actually hypoglycemic (have low blood sugar). In these cases, treat their low blood sugar. Make sure it climbs above 100mg/dl before your child goes back to bed.

If a child’s blood sugar is too high, they may wake up more often saying they’re thirsty or need to go to the bathroom. For some children, this change in nighttime routine is an early symptom that leads to an initial diabetes diagnosis.

poor sleep, hormones and blood sugar

Poor sleep, like less than six hours, has been linked to higher blood sugar levels the next day in patients with diabetes. This can lead to low energy, less activity and maybe more snacking.

When we don’t sleep well, our hormone levels change. Poor sleep can cause:

  • A rise in cortisol, the stress hormone, which can impact insulin and insulin resistance
  • Feeling hungrier than normal
  • A rise in ghrelin, the “hunger hormone” which makes us hungrier
  • Lower levels of leptin, a hormone that makes us feel full

All these changes may cause children to eat more after a bad night of sleep. That can lead to higher blood sugar.

managing blood sugar and sleep

How can you manage blood sugar changes the day after a bad night of sleep? It all comes down to close monitoring and planning.

close monitoring to keep balanced sugars

Keep an eye on blood sugars with frequent finger pokes or with a continuous blood glucose sensor. This close monitoring can help you catch any spikes or lows, and quickly treat them to keep your child’s levels balanced. With balanced blood sugar levels, sleep should be no problem!

stay active

It’s also important to stay active! Exercise can help lower blood sugars and increase energy, even after a bad night of sleep. If your child is feeling tired, suggest they be active rather than take a nap. Napping may affect your child’s sleep schedule and make maintaining their blood sugar levels harder.

eat mindfully

We’ve talked about how poor sleep can impact hunger. So, sticking to a specific diet plan can help manage your child’s blood sugar levels. Encourage your child to eat healthy foods from all food groups. Help them avoid unhealthy snacking or overeating that can cause blood sugar spikes.

If your child still has a hard time sleeping and keeping their blood sugar levels in check, it is time to visit their pediatrician/primary care provider or endocrinologist. These experts can help you learn more ways to manage your child’s diabetes and keep them happy and healthy!

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care that goes above and beyond

Because every child deserves care that goes above and beyond, Dayton Children’s provides compassionate, expert care for kids of all ages. Find a provider, schedule an appointment, or learn more about conditions we treat today.

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conditions we treat

empathy in action: the role of community health workers in asthma treatment

woman helps young child with asthma inhaler

Asthma is a significant challenge for more than 4.5 million children under 18, impacting their daily lives, aspirations and dreams. At Dayton Children’s, we are dedicated not only to treating asthma but also to enhancing the overall wellness of every child living with this condition. 

Our Community Health Workers (CHWs) play a pivotal role in this mission, serving as important links between our patients and the resources that can transform their lives. By reaching out to families after a diagnosis, CHWs empower them with the knowledge and tools they need to manage asthma comprehensively, fostering resilience and a brighter, healthier future. 

CHW’s like Precious Brown have a unique connection to our community which impacts the way they carry out their job.  

Precious’ path: making a difference as a Community Health Worker

“I always wanted to give back to the community in which I grew up and helped mold me into the woman I am today. The only issue was I was unsure of how to fulfill that passion.” 

Precious Brown, community health worker, has been serious about her mission to make a difference in this community.  

When the opportunity was presented to join the team at Dayton Children’s, she was excited to be supported in pursuing her Masters in Public Health while also fulfilling her lifelong dream of helping others.  

“Being in this position, the impact that we are able to make for the families we serve is inexplicably rewarding,” shares Precious. “I remember when I was growing up I would watch my mom do things for people around her. Whether it was just a conversation or a gesture, I would see a sense of relief present on their faces and in their body. It was like a language that brought a calmness to everyone who was there to witness.” 

For Tabitha Miller, when her 8-year-old son Mason was diagnosed with asthma at Dayton Children’s, the presence of a CHW made her feel instant relief.  

“I started crying when she called me and she shared how she could help,” explained Tabitha. “I thought this was a blessing to have that extra help instead of just going to the doctor.” 

above and beyond support for asthma patients

So what exactly is the role of a CHW? It may be hard to label but easy to tell that it makes a big impact.  

“Sometimes we are therapists, educators, advisories, mediators and the lists can continue,” says Precious. “But of most importance we are advocators. As asthma Community Health Workers, we strive to help patients and their families healthily manage their asthma. This can look many ways, such as providing education to the patients about medication, environmental triggers, the importance of making office visits and what to do when symptoms are present and threatening.” 

Beyond education, CHW’s may also provide allergen bedding, swifter dusters, green cleaning buckets as an alternative to using harmful and asthma triggering chemicals, HEPA vacuums, spacers and more. All to limit the patient’s exposure to triggers that could cause irritation to the airways and provoke their asthma symptoms. 

Of course our CHWs also go above and beyond like Mekayla Pullins, who is the CHW for the Miller family.

A Community Health worker poses with an asthma patient

“She goes with us to doctors’ appointments. She’s always messaging to see how Mason is doing. She met up with us last minute because my son does not like taking his steroid inhaler to help with his asthma and he was going to have to start taking shots once a week and she printed off some papers and explained everything to us and he’s been doing his breathing better since!” 

By holistically helping the family to improve factors, stressors and triggers, it can make outcomes for the child patient much better! 

“What I think most are unaware of when it comes to asthma, is that it can be deadly. Asthma is a life-threatening disease and should be treated as such. Therefore, if you are unfamiliar with the effects of asthma and you help asthmatic families at any capacity try and find time to research do that you are best equipped to help these families.” 

the importance of asthma awareness

By raising awareness, people are more likely to recognize the signs of asthma, seek appropriate medical care, and understand how to manage the condition effectively. Additionally, increased awareness can lead to advocacy for policies and resources that support asthma prevention, research, and access to quality healthcare for asthma sufferers. Ultimately, the purpose of raising awareness is to enhance the quality of life for people living with asthma and reduce the burden of the disease on society. 

Today, Mason is an active kid who is excited to start playing football this year! Thanks to support and guidance from CHWs, this is possible and our hope for all kids!

 “I find it important to not assume that everyone around you, including the families, are as knowledgeable. So, educate profusely but not with the absence of compassion. Extend grace and patience and make sure that you are serving each case uniquely because it will be most beneficial,” shares Precious.  

To learn more about our CHW program and our hospital’s commitment to health equity, click here.  

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care that goes above and beyond

Because every child deserves care that goes above and beyond, Dayton Children’s provides compassionate, expert care for kids of all ages. Find a provider, schedule an appointment, or learn more about conditions we treat today.

find a provider
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conditions we treat

a breath of change: asthma awareness month and advancing health equity for children

Aaryn, a Dayton Children's patient, recently achieved her dream of making the cheerleading team

When Aaryn was just six months old, she found herself at Dayton Children’s Hospital, struggling with a severe respiratory illness called RSV. During her stay, the doctors made an important discovery: Aaryn had asthma, a condition that made it difficult for her to breathe freely.

Now Aaryn is 15 years old and although she’s accomplished her dream of making the Thurgood Marshall High School cheerleading squad, she sometimes still struggles with asthma flare-ups especially when the weather changes.  

“I tell her, she can’t be like other kids- even when she wants to. She needs to learn how to manage her asthma,” said Jeanine Belcher, Aaryn’s mom. Jeanine says she recognized that better asthma control was essential for Aaryn’s well-being. 

from research to action: addressing the disparities to treating asthma

Aaryn is far from the only child in the Dayton area struggling with complications from asthma. The Asthma and Allergy Foundation of America 2022 Asthma Capitals report ranked Dayton 24 in the country for most difficult places to live with asthma. Dayton also ranks fourth highest for asthma-related emergency department visits and fifth highest for quick-relief medicine use. For years, Dayton Children’s Hospital’s Community Health Needs Assessment has pointed to asthma as a top pediatric health concern. 

Dayton Children’s has been researching to understand how asthma affects the children in our own community. We’ve discovered that there are some differences across races and socioeconomic status that can impact their struggles with asthma. It’s important for us to recognize these health disparities. 

In a recent article published in the Journal of American Medical Association (JAMA), experts found that Black and Hispanic children have a higher likelihood of developing asthma and experience it at an earlier age compared to White children. Furthermore, they also noticed that kids growing up in areas with more low-income households and higher poverty rates were more prone to asthma diagnoses. These findings highlight the need for us to address these disparities head-on. 

the difference the Dayton Asthma Alliance makes

That’s why we’re proud to have established the Dayton Asthma Alliance here at Dayton Children’s Hospital. Our goal is to tackle the underlying structural and policy issues that often hinder children with asthma from achieving the best possible health outcomes. We work closely with our Medical-Legal Partnership for Children who can support families with asthma who may be living in housing that is a barrier to health. We are also working with housing partners to address housing issues such as mold and pests which can trigger asthma. 

Thanks to the Dayton Asthma Alliance the Community Health Worker program has grown and expanded at Dayton Children’s, which is how Aaryn found a perfect match in a dedicated community health worker who became her trusted guide and superhero. The community health worker not only answers all of Aaryn’s questions about medications and treatments but also provides help with insurance and paperwork when Jeanine needed it.  

“They are so helpful. Any questions I have they answer within 24 hours and they send me useful information to my mailbox,” says Jeanine. “I was so happy to find out that Dayton Children’s had this program because I’ve been waiting for Aaryn to get the help that she needs!”  

By taking a holistic approach that combines medical care, addressing social needs, and advocating for policy changes, we’re striving to create a healthier environment for children with asthma in our community. At Dayton Children’s, we believe that every child deserves the chance to breathe easy and enjoy a happy and active life, regardless of their health condition. 

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care that goes above and beyond

Because every child deserves care that goes above and beyond, Dayton Children’s provides compassionate, expert care for kids of all ages. Find a provider, schedule an appointment, or learn more about conditions we treat today.

find a provider
schedule appointment
conditions we treat

the dos and don’ts of a gluten-free diet

how to navigate the dietary restrictions of a child with celiac disease

Chef holding wheat while holding stomach, signaling a gluten allergy

If your child has celiac disease, their doctor will guide you on which foods your child can eat and which to avoid. These changes will have a big impact on your family’s everyday life and your child’s diet. You may also benefit from meeting with a dietitian for more advice.  

Your child’s diet should have no wheat, barley, rye or related grains. No law requires food manufacturers to list gluten on food labels, so making sure your child avoids it can be hard. In the United States, all food must be clearly labeled if they contain any of the top eight food allergies, including wheat. But wheat-free doesn’t mean gluten-free. Some wheat-free products may have gluten-containing grains like barley and rye in them. 

Carefully read food labels on all items before you buy them or let your child have them. And help your child learn to do it too. According to The Celiac Disease Foundation, these are some of the common foods that contain gluten: 

  • Pastas: raviolis, dumplings, couscous and gnocchi 
  • Noodles: ramen, soba, chow mein and egg noodles 
  • Breads and pastries: croissants, pita, naan, bagels, flatbreads, cornbread, potato bread, muffins, donuts, rolls 
  • Crackers: pretzels, goldfish, graham crackers 
  • Baked goods: cakes, cookies, pie crusts, brownies 
  • Cereal and granola: corn flakes and rice puffs often contain malt extract/flavoring, granola is often made with regular oats, not gluten-free oats 
  • Breakfast foods: pancakes, waffles, French toast, crepes and biscuits 
  • Breading and coating mixes: panko breadcrumbs 
  • Croutons: stuffings, dressings 
  • Sauces and gravies: many use wheat flour as a thickener 
  • Flour tortillas 

The good news is many of the food items listed above are now available in gluten-free options as well. Just be sure to read the label! 

other foods that may contain gluten 

These foods must be verified by reading the label or checking with the manufacturer/kitchen staff: 

  • Energy bars/granola bars 
  • French fries 
  • Potato chips 
  • Processed lunch meats 
  • Candy and candy bars 
  • Soup 
  • Multi-grain or “artisan” tortilla chips or tortillas 
  • Salad dressings and marinades 
  • Starch or dextrin 
  • Brown rice syrup 
  • Self-basting poultry 
  • Pre-seasoned meats 
  • Cheesecake filling 
  • Eggs served at restaurants 

finding safe options 

  • Start with the foods your child can eat. Safe foods and ingredients include foods made with flours of corn, rice, buckwheat, sorghum, arrowroot, garbanzo beans (chickpeas), quinoa, tapioca, teff and potato. All plain meats, fish, chicken, legumes, nuts, seeds, oils, milk, cheese, fruits and vegetables are also okay. 
  • Watch for cross-contamination. Sometimes, gluten-free foods can come into contact with foods that contain gluten. For example, crumbs from regular wheat bread can find their way into jams, spreads or condiments if people aren’t careful to use a fresh knife or utensil each time. Keeping condiments in squeezable bottles and using separate butter, jams and spreads for people with celiac disease is a great idea. You might also keep a separate toaster for gluten-free bread. 
  • Clean appliances, utensils and work surfaces before you make gluten-free products, especially after handling foods that contain gluten. Wash your hands well and often when you prepare food. 
  • In restaurants: Tell the server or the kitchen staff about your child’s condition so they know that your child’s food must be free of gluten and related ingredients. 
  • In grocery stores: Most carry some gluten-free bread, cereal, baking mixes, cookies, crackers and other products. Health food stores and natural food markets may have wider selections of these foods. Skip gluten-free products from bulk food bins because of the risk of cross-contamination. 

If your child is a patient in gastroenterology at Dayton Children’s and could benefit from more advice on nutrition, contact the clinic to arrange meeting with a licensed dietician at your next appointment.

If your child is not a patient in gastroenterology at Dayton Children’s but would benefit from advice from a licensed dietician, schedule an appointment in our nutrition clinic. 

Information adapted from KidsHealth. 

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care that goes above and beyond

Because every child deserves care that goes above and beyond, Dayton Children’s provides compassionate, expert care for kids of all ages. Find a provider, schedule an appointment, or learn more about conditions we treat today.

find a provider
schedule appointment
conditions we treat

caring for type 1 diabetes and celiac disease

You may have heard that there has been an increase in autoimmune diseases, including type 1 diabetes and celiac disease. We’ve recently seen an increase in patients having both of these diseases together. We talked with endocrinologist Stacy Meyer, MD and gastroenterologist and division chief of pediatric gastroenterology and nutrition Michael Bates, MD to learn more about the connection between the two, and our clinical nutrition team for tips and resources for families whose children are managing both.

why are we seeing an increase in patients with autoimmune diseases, like type 1 diabetes and celiac disease?

Autoimmune diseases are what we call “two hit” processes. You have to inherit the genes that make it more likely to develop an autoimmune disease, and then something else in the environment must trigger the process. Viruses are often triggers to the start of autoimmune diseases, but we don’t know for sure what the triggers might be for these disorders.  Recently, there has been a rise in type 1 diabetes cases that is thought to be associated with COVID infections. 

how are type 1 diabetes and celiac disease linked?

Celiac disease and type 1 diabetes share a genetic link.  Both celiac disease and type 1 diabetes risks are inherited on HLA genes and share two specific HLA types in their inheritance: DQ8 and DQ2. It appears that a person has to have one of these two HLA types to be at risk for celiac disease or type 1 diabetes.  

why might we be seeing an increase in kids having both type 1 diabetes and celiac disease?

It is not currently known why we are seeing an increase in autoimmune diseases, but there are many theories and studies looking into this.  We have been seeing a rise in autoimmune diseases overall since the 1980s.  We also have better screening tests for celiac disease, which has led to an increase in its diagnosis.

what is the impact on a child if they have both celiac and diabetes? What challenges come with it?

The combination of celiac disease and diabetes can be especially difficult to manage. They both require adjustments to our diet and lifestyle that are independent of each other. Many of the foods safe for kids with celiac disease are higher in carbohydrates. This can make it harder for kids to cover with insulin and to keep their weight in a healthy range. 

how can people with diabetes and celiac get carbohydrates? 

People with diabetes and celiac disease should include healthy carbohydrates in their meals every day. These can include fruits, vegetables, gluten-free whole grains and gluten-free dairy products. Most kids with diabetes and celiac disease eat around 30 to 75 grams of carbohydrates at each meal, and 15 to 30 grams of carbohydrates for each snack.

how do I choose gluten-free whole grains?

Check the ingredient list on a food label to see if a food is a good source of whole grains. The first words on the list should be “whole grain [name of grain].”

  • Do not select foods that list the name of the grain as wheat, rye, barley, or oats (unless specified gluten-free oats) – These grains contain gluten.
  • Gluten-free grains include: buckwheat, teff, amaranth, rice, corn, quinoa, sorghum, millet, grits and labeled gluten-free oats.  The package should also be labeled as gluten-free.

what are some other resources for patients and families?

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care that goes above and beyond

Because every child deserves care that goes above and beyond, Dayton Children’s provides compassionate, expert care for kids of all ages. Find a provider, schedule an appointment, or learn more about conditions we treat today.

find a provider
schedule appointment
conditions we treat