Exams with type 1 diabetes: an honest guide for students and parents

Update May 2026

I was diagnosed with type 1 diabetes myself at 29, so I went through high school and higher education without having to think about glucose levels during tests or exams.

But in the years I've been running Tinsulin and in contact with the diabetes community, I hear the same stories every spring. Teenagers panicking before their exams. Parents unsure if they're allowed to ask "how were your levels?" or if that adds too much pressure. University students suddenly having inexplicably high levels during their sessions, even though they're doing "everything right."

This guide was written with input from people who personally experience it: students and parents from the community. Intended as practical support, not as medical advice (see disclaimer at the bottom).

Below you will find, in order: the medical explanation of why your levels fluctuate during exams, the mental aspect, how to prepare, a checklist for your bag, your rights at school, a section for parents, and an FAQ.

1. Why your glucose often acts up during exams

Many T1Ds are shocked by their glucose curve during exam periods. High spikes without a clear cause, unexpected dips after a stressful moment. No coincidence: it's your body reacting to stress.

Stress hormones. Cortisol and adrenaline are released when you're stressed. Cortisol prompts your liver to release extra glucose, which raises your blood sugar. A dip often follows when you relax again.

Foggy brain with high levels. Many people don't know that hyperglycemia impairs concentration. It's not just fatigue; it's also slower thinking, difficulty finding words, and trouble focusing. Nothing to do with intelligence, everything to do with your glucose.

Sleep deprivation. Lying awake due to study stress or a night with alarms leads to more erratic levels the next day. So, sleep during this period is not a luxury; it's exam preparation.

Important to know: a high level during or just before an exam is usually not your fault. It's your body doing what it's supposed to do under pressure. Be kind to yourself and your curve in these weeks.

2. The mental aspect: double pressure

Exams demand a lot from every student. With type 1 diabetes, there's an extra layer. You not only have to perform in your subjects, but you also have to continue "managing" something that requires 24/7 attention.

In my DMs, the same things come up every spring:

• Guilt about a high reading during a stressful week
• Frustration about a hypo that comes at just the wrong moment
• The feeling of having to work harder than classmates to achieve the same result
• The pressure to score "perfectly" on both your report card and your CGM

That's a lot. Really a lot. And it needs to be said.

One thing I often hear helps: letting go of perfection during this period. Not striving for the most beautiful curve, but striving for safety and stability. A "good enough" week during exam period is a top week.

3. Arranging things in advance: the conversation with your school

This might be the most important tip in this entire piece: arrange things at school well in advance. Not on the exam day itself, not the day before, but weeks ahead.

What should you discuss?

• What a hypo or hyper looks like for you personally
• What they should do if they see you struggling
• Which items are allowed on your desk (glucose, water, meter)
• Whether you can use your phone or CGM scanner for your readings
• How a hypo break is arranged (see also point 5)

Ask your endocrinologist or diabetes nurse for a note stating your rights and needs in writing. This prevents discussion at the moment itself.

4. What's in your exam bag: the checklist

Specific items you'll want to bring:

• Glucose tablets or dextrose, enough for at least 2 hypos
• 1 liter of water (minimum)
• A snack for afterwards (banana, cookie, granola bar)
• Sensor scanner or phone, with pre-arranged permission
• Diabetes card or medical ID
• Spare patch or fixtape for your sensor or pump
• Backup insulin pen, as a backup for your pump + needle
• Tissues, for sticky fingers after a hypo snack

Tip: prepare this package the evening before each exam. One less thing to think about in the morning.

A good sensor patch or fixtape is also not a luxury in these weeks. A sensor coming off halfway through your exam is precisely the stress you don't need right now. View the patches and fixtapes we have in the shop here.

5. Your rights as a T1D student during exams

Many T1D students don't know they have the right to accommodations during exams. In Flanders, this falls under reasonable accommodations for students with a chronic condition, in the Netherlands under a similar regulation.

Three important rights:

1. Glucose and water on the table. Not cheating, just medically necessary.
2. Hypo break. In case of a hypo, you may briefly interrupt the exam. This time does not count towards your exam time, provided this has been arranged in advance.
3. Scanner or phone in sight. With permission, you can check your CGM data during the exam. Not for social media, but for your glucose levels.

Request this through your care coordinator, class mentor, or student counsellor. The sooner, the better. Get everything in writing to avoid any discussion on the day itself.

6. For parents of a T1D during exam period

A short message for the parents reading along.

What your teenager or young adult needs most is not extra monitoring of grades or levels. Not "how were your levels just now?" every twenty minutes. No panic at every outlier.

What does help:

• Someone who understands that high levels during exams are often not "fault," but stress hormones
• Someone who keeps it practical: offering a glass of water, preparing a snack, asking if anything is needed
• Someone who reminds your teenager that they already do more than their classmates every day, exam or not
• Someone who doesn't constantly ask if they "did" eat, prick, or bolus

Exam period is stressful for every parent. For parents of a T1D, even more so. But know this: your calm presence is seen, even if it's not explicitly stated.

7. FAQ

Can my phone be on the table for my CGM data? In many schools, yes, provided you have requested this in advance and have written permission. Discuss this with your care coordinator. State that the phone is only for glucose monitoring, not for other apps.

What if I have a hypo during an oral exam? Report it immediately. Drink, eat some sugars. Ask for a short break. The time you lose to a hypo should not be deducted from your oral exam time if you have requested this in advance.

Am I allowed to bring snacks into the exam room? Yes, provided they are glucose tablets or a snack for medical purposes. This does not fall under "unauthorised aids."

What do I do with my insulin pump during exams? Just let it run as usual. Discuss in advance whether you are allowed to operate your pump during the exam (for a correction or a temporary basal rate).

What if I cannot finish the exam due to my diabetes? In exceptional cases (severe hypo, severe hyperglycemia), an exam can be postponed or retaken. Ask your doctor to attest to this if necessary.

Finally

Exams with type 1 diabetes are no small feat. Whether you're in high school, higher education, or getting your driver's license: just getting up, pricking, planning, and on top of that studying and performing, that's double the work that is rarely seen.

Are you supported in this? Great. Are you doing it mostly alone? Also great, and know that thousands of T1Ds across Flanders and the Netherlands are experiencing the exact same thing right now.

What's your best tip for exams with diabetes? Let us know below or send me a DM on Instagram. Other students and parents are reading along, and together this guide will only get stronger.

Good luck with your preparation. You're doing better than you think.

DISCLAIMER: the information above is based on personal observations, conversations with the community, and generally available information. It is not medical advice in any way and is not intended to replace professional medical advice for specific complaints. Always follow the advice of your healthcare provider and do not make changes to your insulin dosage without consulting them first.