How To Prepare Your Teen With Diabetes for AP Exams



It’s AP exam season, aka a year’s worth of learning crammed into one three hour test. It’s a challenge for every student sitting the exam. Throw diabetes into the mix and the challenge may be tougher. But like anything with diabetes, it can be done well with proper planning.

My daughter Kate, a sophomore in high school, has two AP exams this year. She is no stranger to the “big” tests–she’s already taken the PSAT and the ACT, so we’ve had a plan for tests in place for years. But as she learned a few weeks ago, having a plan and actually using the plan are not always the same thing.

Our 504 plan states that Kate is allowed to check and treat blood sugar anytime, any place. Specifically, she is allowed to have her meter, strips, water, and something to treat lows on her desk during any tests, including standardized tests. She knows her 504 plan, but she is a teen. And sometimes she makes mistakes.

And she did make a mistake on the day of a practice DBQ (document based question). It was the last period of the school day. She felt a little low, checked her cgm, and saw her blood glucose was in the 90s. She realized that she left her low supplies with her lunch, but figured she could make it to the end of the day by using the temporary basal feature on her pump to shut off her basal insulin during the test. Halfway through the essay, the drop in blood sugar hit. She was shaky, sweaty, and praying for the essay to be over so she could get candy from another teacher who was not in the testing room. Surprisingly (and miraculously) that teacher walked into her classroom with a cup of candy! Kate was able to get the teacher’s attention and treat the low.

It was a teachable moment for Kate and for her teacher. It reminded us to better prepare for the real AP exams. Her personal responsibility is to eat a good meal before the exam, have a snack during the break time, and have ready access to low supplies. She doesn’t worry about high blood sugar during testing unless she has ketones, which make her sick. She knows that she will have a meal spike an hour or two after eating and that she shouldn’t correct that spike or she will drop like a stone.

The school/testing facility also has responsibility to accommodate. There should be a documented disability form on file at your child’s school. The College Board (SAT, PSAT/NMSQT, and AP Exams) requests the documented disability and a brief description of the impact of stress on blood glucose level fluctuations, plus the treatment regimen. Your school also needs to have requested accommodations for testing on file. Some common accommodations are: allowing all diabetes supplies (meter, lancet, strips, water, food to treat lows) to be easily accessible to the student during the exam, and/or stopping the clock to treat any highs or lows. Keep in mind that school accommodations do not automatically qualify for College Board testing accommodations, although most do.

The ACT has its own policies regarding accommodations. A student with diabetes may choose to use National Standard Time with Accommodations, meaning they make take the exam at a regularly scheduled testing center with set time limits but with accommodations such as having permission to eat snacks in the test room or National Extended Time (50% extension), which allows the student to have up to five hours total to complete the four sections of the exam and an additional 45 minutes if the ACT Plus Writing is included. It is common for students with diabetes to request the National Extended Time, but not all feel the need for extra time. Remember YDMV (your diabetes may vary)!

Kate had two AP exams this year. I know that a good night’s sleep, a healthy breakfast, snack during break, and her meter nearby, helped her get through the exams with no blood sugar issues. Now we just have to wait for the exam results! Good luck to all AP students! May July bring good numbers— BG and AP scores alike.


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Catherine Alger
Catherine Alger
4 years ago

Technology is changing and IMO, with it should come changes in “rules”. I have, over the past week, been in discussions with ACT about allowing Dexcom receivers only (no Internet or any other capability) on the desk to allow minimal interruptions and allowing the least break in concentration. I have talked at length to them about the lack of any way to cheat on the test. In fact, is is more harmless than the calculators they allow. It would take little for them to understand this technology and what it means to someone that uses it to keep BG near… Read more »

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