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From New Jersey, USA:

I'm a medical student with type 1 diabetes. I find it really difficult to control my blood sugar and manage my classes. I feel like I've neglected my health since the moment I got to medical school. My A1c jumped from 6.0 to 8.5 and has been there for two years now.

I need some advice on how to manage my blood sugars more effectively when I have very little extra time during the day. Also, do you have any suggestions, tricks or ideas on how I can remind myself to check my blood sugar when I'm running around from class to class and patient to patient?

I think this is particularly upsetting because everyday I learn another complication of diabetes in school and all the while, I know I'm not doing what I need to be in good health.


I have counseled several wonderful medical students; most are now graduated physicians. They are all great people and deal with an extra burden that adds stress to their life. It doesn't seem fair to have to deal with that, but there is no getting around you what you have to do. Please realize you will face this the rest of your life. Your busy professional life will require you to have some model for how to keep up with your diabetes, or your schedule will be to your detriment.

First, take the time. It is only fifteen minutes out of every day that you will need to commit to your self-care. Second, consider an insulin pump, if you don't already have one. The pump allows you to make adjustments and increase your flexibility, which you would never get from intermittent injections. Third, find a mentor, physician of some sort that can follow you. You can't be in medical school and be your own physician. Fourth, realize you will have patients with diabetes. They will look up to you. Learn how to succeed and be a model for them. Fifth, realize that some days won't be as good as others. It would be ironic that you would go into medicine only to have this be a medical problem for you. Many people go through this struggle and find a happy medium. Finally, I have seen our students succeed and succeed at a high level. You can, too. Many people who talk about the complications of diabetes only take care of people with poor control and who have had poor control for most of their life. This has been a constant comment from our students. It is not like that at all for many patients.

Best of luck and much happiness. You are starting a career in a wonderful profession.


Original posting 27 Oct 2004
Posted to Daily Care


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