With or without diabetes, going to college is a significant transition.  Learning how to live on your own is a big adjustment that is made up of a lot of little adjustments, such as new friends, new classes, and new living arrangements.  For college students with diabetes, however, managing blood sugar and insulin levels away from home is one of the most difficult and important adjustments. 

This fall was my first semester at college; besides doing well in my classes and making good friends, staying healthy was one of my top priorities.  I was especially diligent about testing my blood sugar, changing my set every few days, and counting carbs.  Especially in the beginning, I had to make a lot of little changes to my usual regimen in order to accommodate an erratic college schedule. 

The first week of classes, I found myself low three or four times a week.  I slowly decreased my basal rate and increased my sensitivity and carb ratios until my blood sugar stabilized. I was surprised that I needed less insulin at school than I did over the summer, especially given the amount of running I did to train for the Pikes Peak Ascent.  I had expected to increase my insulin levels as I decreased my weekly mileage. 

I began to search for an explanation for all the lows.  I realized that even though I was running less, I was actually walking more.  The extra activity, although it wasn't totally intentional, was influential enough to affect my daily totals by about six or seven units a day!  

I did a little research, and I learned about Non-exercise Activity Thermogenesis, or NEAT.  According to James A. Levine and his research at Mayo Clinic Research, NEAT is spontaneous physical activity that all human being exhibit. 

There are three main components of human energy expenditure (EE).  The first is basal metabolic rate (BMR), which represents the energy that your body uses at complete rest.  The second is the thermic effect of food (TEF), or the energy that your body needs to digest and break down food.  The final component is activity thermogenesis, or the extra energy that your body needs based on physical movement.

Activity thermogenesis can be intentional, through the form of exercise-related activity thermogenesis, or less intentional, through NEAT.  When most people aim to increase the number of calories that they burn in a day, they focus on increasing their exercise-related activity thermogenesis by working out more.  However, they often neglect to reflect on all of their smaller movements- walking up the stairs, sitting and standing, and even fidgeting.  Over to the course of a day, these non-exercise based activities end up using much more energy than we realize!  According to Levine, NEAT, even in avid exercisers, is the predominant constituent of activity thermogenesis.  After all, it is the EE associated with all the activities we undertake as vibrant, independent beings.