Diabetes Care

The Campus Health Diabetes team can provide your complete diabetes care or supplement care with your endocrinologist. Our diabetes team members include physicians, dieticians, and a clinical pharmacist - all of whom have advanced knowledge of diabetes.

Team Members:

Caitlin Heredia, PA-C

Dr. Joseph Cefalu, MD, MS

Dr. Elizabeth Breeden

Ashley Kelley, MPH, RD, LDN

Counseling and Psychological Services also assists in our team care approach. 

For the best diabetes care, visit your diabetes care provider at least every three months. This helps your provider know you when you are well and take better care of you if you become ill.

Appointments can be made by phone or through the Healthy Heels portal.

• By phone, mention that you have diabetes, which will help enough time be scheduled for your appointment. You may also indicate which of the team members you would like to visit. If you are ill, call early.
• On the portal, fill in the notes section with your diabetes care needs. You may also indicate here which of the team members you would like to visit, as some of them are not listed in the provider dropdown menu.

• Your glucose meter, insulin pump (if you use one), and/or CGM (if you use one),
• Any medications you are currently taking, and
• A recent 3-4 day log of your insulin doses, blood sugars, carbs and movement.

Call 911 if you are experiencing a life-threatening medical emergency.

For urgent needs, call 919-966-2281. After hours, this number connects with Health Link, a nurse advice system associated with UNC Health Care. They can help you determine what you need to do next, including connecting you with a provider on call if needed. 

Same Day Care is also available for urgent needs. Wait times for those without an appointment will vary. Appointments are encouraged to help limit wait times and to provide safe, efficient care.

• Recent changes or concerns 
• A1c- target < 7% or lower if not having significant hypoglycemia
• Blood pressure - target < 130/80 mmHg
• Foot exam and foot care
• Insulin plan or other treatment: what's working and what to improve
• Fitness plan/ways to be active
• Monitoring 4 times a day or more if treating with insulin and using those numbers to improve results
• Low blood sugar plan - always carry sugar to treat lows quickly, glucagon
• High blood sugar plan - insulin correction doses, ketone testing
• Insulin pump safety
• Sick day care
• Stress management
• Contraception/pre-pregnancy planning
• Preventing heart disease (not smoking, blood pressure, cholesterol management, and aspirin therapy)
• Preventing diabetes-related complications
• Alcohol use and its effect on blood sugar

• Lipids (cholesterol), creatinine (kidney function) and microalbumin (protein in urine)
• Eye exam (Dr. Meredith at UNC Hospitals is a diabetes retina specialist 919-966-5296)
• Flu vaccine in October or November
• Dental visit 1-2 times a year

One pneumococcal vaccine dose (Prevnar 20) is recommended for all individuals 19 years and older with diabetes or other risk factors.

Alcohol swabs 

Glucose gel 

Glucose 4 gram tablets 

Sharps container (BD) 

Also, please review the Pharmacy Formulary for medications available at Campus Health Pharmacy and Student Stores Pharmacy. 

• Diabetes online community resource guide from Beyond Type 1
• Association Of Diabetes Care and Education Specialists (ADCES)
• American Diabetes Association (ADA)
• Beyond Type 2
• Canadian Diabetes Association (CDA)
• Centers for Disease Control (CDC)
• College Diabetes Network - specific to the concerns of young adults with Type 1
• Diabetes and Heart Disease - Mayo Clinic
• Diabetes Net
• Diabetes Prevention - 50 Ways to Prevent Diabetes: NIH - National Diabetes Education Program
• Diabetes Prevention - The Healthy Plate Method: New York State Department of Health Diabetes Prevention
• DiabetesSisters 
• diaTribe - Research and product news for people with diabetes
• JDRF Juvenile Diabetes Research Foundation
• MedicAlert Foundation Home Page
  Provides necklaces, bracelets, etc. for emergency medical information and identification
• National Institute Of Diabetes And Digestive And Kidney Diseases (NIDDK)

• Stock up on the supplies you will need: test strips, insulin, syringes, urine or blood ketone strips, glucagon.
• Wear a Medical ID.
• Carry sugar with you.
• Be sure people around you are aware you have diabetes and know how to help if you have a low blood sugar. Teach your roommates and friends how to give glucagon. Discuss a plan for sick days with your doctor.
• Know how to dispose of your used syringes, pen needles and lancets. Different counties have different requirements; be sure to review your county's requirements. 

Contact Accessibility Resources & Service if you need to make changes in your class schedule in order to accommodate the management of your diabetes. Discuss your class schedule needs, such as changing course times or days to allow for reasonable lunch breaks.

For nutrition facts for campus food choices, see Carolina Dining Services. For special nutrition needs, ask to speak with the dietitian in Rams Head Dining Hall - (919) 962-2352. For a review of carbohydrate counting, try this website or ask your diabetes educator or nutritionist. You may want to keep a small refrigerator in your room to keep food items available. Some suggestions for healthy cafeteria foods are:

• Lenoir upper level - traditional cafeteria
• Lenoir lower level - 1.5.0 (for local and organic options), Mediterranean Deli (top-rated local healthy choice), Healthy Bowl, soup and salad bar 
• Rams Head Dining Hall - full salad bar, heart-healthy choices, fresh fruits

Campus Health offers many services for students and post-docs with diabetes, including a group of providers with advanced diabetes knowledge, a Certified Diabetes Care and Education Specialist, and nutritionists. Visit early in the semester for a good start.

Check blood sugar before exercising. Learn how many carbohydrates you need to balance exercise (usually 25-30 grams for every 30 minutes of exercise). Tell your exercise partner to give you sugar if you become confused. For heavier exercise than usual, discuss a reduction in your insulin with your physician. For help in developing an exercise plan, check out all that is available through Campus Recreation and visit the Student Recreation Center's Functional Movement and Fitness Center for their FREE drop-in fitness services. 

For young adults, taking care of your sexual and reproductive health is important. Resources include Student Wellness, Campus Health Primary Care Clinics, and Gynecology. Screening and treatment of sexually transmitted infections, Pap tests, and contraception are all available. Contraception and planning ahead are especially important for young people with diabetes who could become pregnant, since normal blood sugar control before pregnancy prevents birth defects. 

Falling asleep and missing a meal? Sleeping too late to get all your diabetes care done before that 8:00 am class?

• Try "Defensive Sleep": get to bed early enough to stay in control and feel good the next day.
• Be sure you get breakfast after giving your morning insulin. Discuss your insulin plan with your physician:  a multi-dose insulin program or pump allows more flexible mealtimes, keeping your blood sugar level if you miss a meal.

Give your roommate and close friends instructions for emergencies. Instruct them to call 911 if you pass out. It is helpful for them to know how to give glucagon in case of passing out due to severe low blood sugar. The staff at Campus Health Pharmacy (919) 966-6554, Student Stores Pharmacy (919) 966-8166, or Campus Health Same Day Care (919) 966-2281 can help teach your roommate or friend when and how to administer glucagon.  

Stay sober so you recognize hypoglycemia. Ask a responsible person to give you a sugared soft drink or glucose tablet if you seem confused. Wear a MedicAlert ID. It could save your life. Get a ride. Do not drive if you have consumed alcohol. Hypoglycemia and alcohol both impair driving and judgment. Carry sugar. Plan ahead so that drinking does not affect your diabetes control or class performance. If you choose to drink alcohol, remember it may cause a serious low blood sugar even hours later. It takes an hour per drink for the hypoglycemia risk to clear. Plan to monitor and eat during and after drinking alcohol. Carry sugar with you as you go home. Set an alarm every 2 hours to recheck your blood sugar overnight.

Ask for help! If you're feeling overwhelmed, anxious, stressed, or alone.

• Reach out to UNC Counseling and Psychological Services - first time brief assessments available without an appointment Monday - Friday
• Consider accepting support from groups for people with diabetes, both local and online. See this blog post for some ideas.
• Access an excellent diabetes resource collection from the Diabetes Hands Foundation.