Hannah Went to College. Diabetes Went With Her.

For Hannah Manis, adjusting to living with diabetes in college was a breeze, thanks to Abbott's continuous glucose monitor.

DIABETES CARE|Jan.24, 2022

When Hannah Manis was 3, she was diagnosed with type 1 diabetes. She didn't love the regular insulin injections she needed, and she hated the multiple daily fingersticks required to check her blood sugar even more. She understood why she needed them — but that doesn't mean she was happy about it.

But one conversation changed everything.

While at the hospital, a nurse told Manis's father about something that could simplify her diabetes treatment: a FreeStyle glucometer, which would let Manis draw a sample from her arm instead of her fingertips. Freed from fingersticks, living with diabetes could be that much easier. Just a year later, Manis was administering her own insulin shots under supervision of her parents.

By the time she was in sixth grade, she'd mastered carbohydrate counting, troubleshooting her insulin pump and maintaining her daily health.

"From the get-go," she said, "the FreeStyle products made me a whole lot less scared and helped me take control over this disease."

It didn't hurt, either, that she had great support in her corner.

"My parents and sister were so incredible in making me feel independent over this disease," she said. "They would say, 'You're Hannah with Diabetes, not Diabetes Hannah.' I'm in control; it's not in control over me. Having that mindset really affects the way you take care of yourself as a whole."

New Freedoms, New Choices, New Challenges

Life changed for Manis when she packed up and moved out to college at East Tennessee State University, halfway across the state from her hometown. Suddenly, she was far away from her friends and the comforts of home. Her routine, carefully honed over several years, was upended.

Managing diabetes while finding her footing with her newfound freedom took some navigating. Food preparation, in particular, was a challenge. Eating in the dining hall isn't the same as helping mom cook dinner.

"My parents bought groceries at home, and there was rarely junk food there," Manis said. "So once I was on my own it was on me to decide how to take care of what to eat. I have a full schedule, so there are often time constraints on my meals."

The transition was difficult. Manis developed her own techniques.

"Learning to meal prep was a big help," she said. "I had an option other than fast food that was a quick fix. I've also learned which restaurants have healthy things that I can eat so I have a backup plan if I'm on the go."

Her advice for students with diabetes who are just starting college? Learn what foods work best with your body and make changes based on your findings. The FreeStyle Libre system — Manis got hers when she turned 18 — was invaluable in helping her understand how carbs metabolize in her body at different times of day, which has helped improve her eating plan.

"A lot of it is just paying attention to patterns in how you feel," she said. "I have higher glucose levels in the mornings, and I've found that if I eat a higher-protein breakfast, I don't have a huge drop in glucose that I'd get after a higher-carbohydrate breakfast like a bagel."

Working In Working Out

When she was in high school, Manis didn't need to make time for exercise. She was in the marching band, so exercise was built into her daily routine. But in grad school, free time is at a premium, so squeezing in workouts between classes, homework, research and social obligations becomes a tricky balancing act.

"I've learned that I need to schedule my time for exercise in advance for the week, because if I schedule it, I'm much more likely to stick to it. I also have a workout buddy to help keep me true to my plan."

Finding time was just the first challenge. Realizing that not all exercise is created equal was another entirely.

"Different exercise affects my glucose levels in different ways," Manis said. "I have to pay attention to what happens when I do cardio versus weightlifting or strength-building. Sometimes it increases, sometimes it decreases. It's something you have to experiment with so you can figure out how to control your blood sugar effectively."

The convenience afforded by the FreeStyle Libre 2 system helps free up space on Manis's calendar. Because she can apply the sensor to the back of her upper arm and leave it in place for a full 14 days, she can focus on schoolwork and her social life, not diabetes management. And with the FreeStyle Libre 2 app, she can use her phone to check her glucose levels in between sets or during a run and never miss a beat.

Managing Stress for Mind and Body

Stress and college life go hand in hand as it is. Tack on the added responsibility of diabetes management to learning how to live independently and maintain good grades, and it's a lot to handle.

Manis's full class schedule and active extracurricular life keep her extremely busy, so she needs to keep an eye on how stress affects how she manages her diabetes.

"Even if I don't feel stressed mentally, my body still shows it," she said. "I'll get sick, or my blood glucose goes high. I start feeling a lot worse, and I have to do a mental and emotional check to see if I'm stressed."

Managing that stress, she's learned, is sometimes about preventing it in the first place.

"I remind myself to take time for self-care, whether that's reading a book, Netflix time, working out or spending time with friends," she said. "Just scheduled times that I take out to be by myself and check in."

And sometimes, she's found, it's best to let everything go — even thinking about diabetes — if only for a minute.

"Filling in for one of your organs 24/7 is not easy," she laughed. "Sometimes I need to give myself a mental break from everything, including diabetes. I’ll check my glucose, and if I am in range, I remember that I have settings on my pump to take care of things, so I don’t have to stress about my levels all the time."

Looking Ahead

Manis found a lot of support in college by connecting with other students who are living with diabetes, through organizations such as the College Diabetes Network and online resources such as Beyond Type 1. It's a practice she plans to continue as she furthers her education, and one she recommends to new students.

"Connecting with other people with diabetes has been so beneficial for me," she said. "It gives you a sense that you're not alone. You can compare notes and learn from each other about what it means and what it takes to manage this disease. It really provides a sense of peace and connection with a larger community."

From the time she was just 3, Manis has strived to live her best life — and she hopes to share that strength with many more people in the years to come. She’s figured out her diabetes treatment and has continued pushing to achieve her goals. Manis earned her M.A. in Clinical Psychology in 2021 and is currently in a PhD program for Clinical and Health Psychology. She works in a pediatric diabetes research lab that focuses on interventions to help kids and teens overcome barriers to treatment adherence. She plans to be a pediatric psychologist to help kids and their families cope with and continue to thrive while managing various health conditions.

*Hannah Manis is a paid ambassador for FreeStyle Libre portfolio. The views expressed are not intended as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary.


FreeStyle Libre 14 day system: Failure to use FreeStyle Libre 14 day system as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at 855-632-8658 or FreeStyleLibre.us for safety info.

FreeStyle Libre 2 system: Failure to use FreeStyle Libre 2 system as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If glucose alarms and readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at 855-632-8658 or FreeStyleLibre.us for safety info.