Transitioning to adulthood while living with type 1 diabetes

For a person living with type 1 diabetes (t1d), the transition from adolescence to adulthood can be so much more than just finding a place to live, earning a paycheck, and paying bills. It's an intricate journey in building a team of healthcare professionals, generating (and maintaining) a budget, finding an adult endocrinologist, and learning new techniques for managing diabetes day-to-day.

It can be complex to figure out alone — but we've got you covered! Here are the biggest considerations associated with transitioning into adulthood while living with diabetes.

Navigating health insurance

Personally, navigating my own health insurance was a huge learning curve. While I was growing up — and even through college — I was able to stay on my parents' insurance plans. But once I had my own job, I realized just how time-consuming and confusing the whole concept of health insurance could be.

My advice is to lean on your parents (or whoever managed your healthcare previously) to help you understand the market, and pick a plan that will work with all the needs of someone living with type 1 diabetes. Someone who understands the related vocabulary — like deductibles, premiums, and out-of-pocket costs — can help you better understand and advocate for your health.

Alternatively, you could enlist the help of an HR representative at your company to guide you through the policy selection process or provide resources to inform your health insurance decisions. If you're currently attending college, many universities offer health insurance plans as well, so don't hesitate to ask.

Budgeting with diabetes

While health insurance is a great safety net, it may come up short when you're faced with all of the supplies and expenses associated with t1d. Most insulin manufacturers offer savings cards to help with the out-of-pocket cost of insulin, and many resources are available online.

It can also help to ask yourself questions. Some diabetes-related thoughts to keep in mind while setting up a budget include:

• How much do you want to pay out-of-pocket for medications and services versus how much you want to pay per month for insurance premiums?
• Do you plan to see several specialists? Is the co-pay more for specialists?
• What diabetes technology do you use? What percentage will insurance pay, and what will you be responsible for?
  

Transitioning to an adult endocrinologist

After you check the health insurance box, it's time to start thinking about making an appointment with an adult endocrinologist. If you're not sure where to begin your search, try calling the customer service line on the back of your insurance card. These representatives can tell you if there are any in-plan endocrinologists near you or any restrictions on which doctors are covered by the plan. Your pediatric endocrinologist's office may also have a list of recommended adult endocrinologists to consider.

It's not uncommon for adult endocrinologists to see more type 2 diabetes patients than those with t1d. This can be frustrating at first, as the office or doctor may not be familiar with all the diabetes technology or management techniques you're using. But try to keep an open mind — and feel free to check out more than one office to find if there may be a better fit.

Managing diabetes day-to-day

Even if you had been managing t1d on your own before this huge life transition, all the other related life shifts can serve to amplify any diabetes struggles you may be experiencing. Know that this is common and millions of other people have gone through the same (or similar) situations. Take it one day at a time, and remember that every high or low blood sugar event is only temporary.

If you start to notice trends or areas that you're consistently struggling with, it can help to make a simple, step-by-step plan for improvement. Here are a few tips to get you started:

• Write down the problem. What's bothering you, and what's causing it?
• Brainstorm strategies or solutions. Are there any things you can do today to improve your situation? What's the first step needed toward resolving the problem?
• Implement your plan. Once you have an idea of how to improve your situation, you can work on implementing it. Telling someone else about it can help hold you accountable and may prompt them to offer their suggestions for a solution.

After a few rounds of practice, you'll learn that you're more than capable of managing this condition. Transitioning to adolescence can be a trying time, but it gets better, as you'll soon start to feel more capable and responsible.

Leaning on a support network

Managing the daily ups and downs associated with diabetes solo can feel isolating. Before moving out on your own, heading off to college, or starting that new job, take time to find a diabetes mentor. Trust me on this one, your future self will thank you!

You might also benefit from reaching out to a peer. You may already know a young adult living through the transition from adolescence to adulthood, but if not, consider asking for a contact from your endocrinologist or support group. You can also find a "diabuddy" to message on social media (there are a bunch of us out there in the diabetes online community).

An unbiased third party — to bounce ideas off of or discuss new situations that arise with diabetes — can be an invaluable resource. Both a peer and your mentor can help you make a plan for your day-to-day care, set diabetes-data sharing boundaries, and motivate you when those diabetes burnout days hit hard.

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