Taking exams

Exam stress and blood glucose

How exam stress can affect blood glucose

Stress can release hormones that cause blood glucose levels to rise. These hormones can also make it harder for injected insulin to work properly.

How blood glucose levels can affect exams

Inconsistent blood glucose levels can affect how your child feels during their exam. If glucose levels go too high or too low it can affect their vision, concentration and make them feel tired or lethargic.

Preparing for exams

Discuss your child’s needs with your Diabetes Healthcare Team, your child and the school. It’s good to do this as early as possible so that you have everything in place for when exams start.

Self-monitoring

It’s a good idea for your child to monitor their glucose levels closely while they’re studying. This can help give you some idea of how stress might affect their glucose levels. A flash glucose monitor or continuous glucose monitor may help you get an idea of patterns throughout a period of time.

Your child might need to adjust their insulin dose if they’re stressed, for example if their glucose levels are running high, they may need to take more insulin. You and your child should discuss this with your Diabetes Healthcare Team to help keep glucose levels in range.

Talk to your Diabetes Healthcare Team

Before you meet with the school, speak to your child and their Diabetes Healthcare Team about what is needed to support your child over the exam period. Some things you may want to discuss are:

• Taking glucose monitors or blood glucose meters into the exam room
• Taking hypo treatments into the exam room
• Allowing your child to choose where they sit
• Arranging supervised breaks for treating hypos, measuring glucose or going to the toilet
• Whether you child wants to be considered for special considerations, where your child’s grades may be adjusted if they have a diabetes-related issue during an exam that might affect their performance or result
• Whether your child may be entitled to extra time in the exam

This isn’t an exhaustive list, and there may be other things that you would like to be included. The school may want a letter from your Diabetes Healthcare Team outlining your child’s needs.

Working with the school

Your child should already have an Individual Healthcare Plan in place at school. This is a document which outlines how your child’s type 1 diabetes will be managed in school and should include what the school will do during exams.

It should include the areas that you discussed with your child’s Diabetes Healthcare Team (see above).

You can make arrangements before your child’s exams so that they can check their phones for glucose readings or receive texts from you if you’re monitoring their glucose levels remotely. Find out more about how to do this by visiting the UCL Hospitals NHS Foundation Trust webpage on exam guidance.

On the day of the exam

When it’s time for the exam, your child should test their glucose in the hours before the exam. If they’re using flash or a continuous glucose monitor, you may be able to help monitor this with or for them, if they’re happy for you to do so (see above on the rules for monitoring your child’s levels during an exam).

Your child may want to have a small snack directly before the exam to stop them from having a hypo during the exam.