Q: Our daughter will be taking college entrance exams this year. How can we make sure type 1 diabetes won’t hinder her performance?

A: Every year, thousands of students with diabetes take the SAT®, PSAT/NMSQT®, ACT®, and AP® exams right alongside their peers. The College Board® and other testing agencies have fairly straightforward rules in place about how to request modifications related to diabetes management (you can find info for the SATs here and for the ACTs here). However, because the process of obtaining modifications can take several months, it’s advisable to check requirements and deadlines for each type of test your child plans to take and make requests for modifications as far in advance of your child’s testing date as possible. If your daughter is interested in taking the PSAT in the fall of her junior year, for example, you should start the accommodations request process in the spring of sophomore year.

What kind of testing modifications should you request? As discussed in the American Diabetes Association’s guide, Going to College with Diabetes: A Self-Advocacy Guide for Students, students with diabetes generally receive two types of modifications: permission to have diabetes care supplies with them in the testing area and modifications to the testing schedule. Be aware that testing agencies have very strict requirements on what may be brought into the testing room. With this in mind, you will want to make sure your child has authorization for the following:

  • Access to blood glucose testing supplies,
  • Access to snacks and drinks to treat hypoglycemia or hyperglycemia, and
  • Access to the child’s insulin pump and/or continuous glucose monitoring system.

Testing agencies also have strict limits on how and when breaks must be taken. In general, students with diabetes can request built-in breaks, i.e., they are scheduled to stop at certain set times in order to treat their diabetes, including testing blood sugar, injecting insulin, eating, drinking, and using the restroom. Or they can request “stop the clock” as-needed breaks for diabetes management. It’s rare for a student to receive additional time to actually take the text.

In some situations, a child may be assigned to a separate room, depending on the modifications, as a way to reduce distraction for other test takers. Even if your child does not typically receive these kinds of modifications in school, it can still be useful to have a plan put in place for testing.

On the day of the exam, have your child bring all documentation for modifications and diabetes supplies, contact information for the testing agency’s disabilities coordinator, and any other paperwork the agency requires. Because your child may come in contact with test proctors with limited understanding of type 1 diabetes, it’s a good idea for her to also bring along some basic literature about diabetes, including symptoms of hypoglycemia. Ask your care team for a fact sheet to include with your child’s paperwork. Your care team can also provide feedback on your testing modification requests based on your child’s unique needs.

–Katharine Gordon is the director of the American Diabetes Association’s legal advocate program.

How Other Parents Deal
“From the time we submitted our accommodation paperwork for the SATs, it took just over a month (about five to six weeks) to receive our approval in the mail. We had registered pretty close to the cut-off date, and I was worried the paperwork wouldn’t come in time. On the test day, the proctors handled the breaks for checks and snacks in a very smooth and coordinated way. Still, it’s the SATs! It was a stressful day for my son, and there really wasn’t anything we could do about that except make sure diabetes didn’t add to the stress.”
–Danielle G., Worcester, Mass., mom of 19-year-old Julian

Lilly Diabetes is proud to support the Diabetes Scholars Foundation, which helps young people with type 1 diabetes achieve their dreams of going to college. Click here to hear from past scholarship winners and find out how your child can apply today!

See more People in the Know questions and answers >

Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

SAT®, AP®, and College Board® are registered trademarks of the College Board. PSAT/NMSQT® is a registered trademark of the College Board and the National Merit Scholarship Corporation. ACT® is a registered trademark of ACT, Inc. All other trademarks are the property of their respective owners.