A-Levels, Uni Exams & T1D: How to Stay in Control

Written By Amy Rouech

Exams are stressful. Add T1D into the mix, and it can feel like an extreme endurance test. Between long revision sessions, lack of sleep, stress-induced blood sugar swing and early morning exams, it’s easy to feel overwhelmed. But don’t worry- you’ve got this!

With the right approach, you can keep your diabetes in check and focus on smashing your exams. Here’s your guide to managing A-levels, university exams and everything in between while living with T1D.

Step 1: Get your Exam Accommodations Sorted

One of the biggest mistakes you can make? Not applying for exam accommodations. Schools, colleges and universities must provide reasonable adjustments for students with Type 1 Diabetes under the Equality Act 2010.

What Accommodations Can You Get?

  • Rest breaks- You can pause the exam clock to treat a hypo or check your blood sugar

  • Extra time- If diabetes affects your concentration, you may be eligible

  • Permission to bring food/ drinks- Jelly babies, glucose tabs or Lucozade are allowed

  • Access to medical devices- You can keep your CGM, insulin pump or meter with you

  • A separate exam room- Useful if you need to check blood sugar regularly

How to Apply for Exam Accommodations

  • GCSE’s & A-Levels: Speak to your school’s SENCO (Special Educational Needs Coordinator) as early as possible. Exam boards require evidence, so your diabetes team can provide a letter.

  • University Exams: Contact the university’s Disability Support Office. Most will set up a ‘Learning Support Plan’ to ensure your needs are met.

If you don’t apply in advance, you might not be allowed these accommodations on the day- so sort it early!

Step 2: Managing Stress, Sleep & Blood Sugar Swings

Why Do Blood Sugars Go Wild During Exams?

  • Stress= High Blood Sugar- The stress hormone cortisol can cause blood sugar to spike

  • Lack of Sleep= Insulin Resistance- Late-night revision can make you more resistant to insulin

  • Adrenaline Dumps= Rollercoaster Levels- Nervous before an exam? Your liver dumps glucose, sending blood sugar high- only to crash later.

How to Stay in Control

  • Check your blood sugar more often- Especially first thing in the morning and before bed

  • Adjust insulin if needed- If stress is causing highs, you may need slight corrections. If you’re having lots of hypos, reduce your basal.

  • Prioritise sleep- Aim for at least 6-7 hours. Sleep deprived = harder to manage blood sugar

  • Use a CGM or set alarms- If you’re prone to overnight highs or lows, CGM alerts or a quick middle-of-the-night check can help.

Step 3: Exam Morning- How to Be in the Best Place to Focus

1. Have a Blood Sugar-Friendly Breakfast

  • Aim for a slow-release carb + protein combo to keep levels steady

  • Good options: Porridge with peanut butter, wholemeal toast with eggs, yoghurt with nuts

  • Avoid: Sugary cereals, pastries- unless you want a blood sugar rollercoaster mid-exam

2. Test Before You Leave

  • Try to be between 5.5-10 mmol/L before heading to the exam

  • If you’re low: Have a small carb snack before leaving

  • If you’re high: Correct if needed but avoid over-correcting, or you might go low mid-exam

3. Pack Your Exam Kit

  • Blood glucose meter/ CGM & supplies

  • Fast-acting glucose (jelly babies, glucose tabs, juice box)

  • Slow-release snack (oat bar, nuts, banana)

  • Medical ID (optional but useful in case of emergency)

4. Arrive Early & Settle In

  • Arriving stressed = higher blood sugar. Give yourself time to test, breathe and get settled.

Step 4: What to Do If Your Blood Sugar Messes with Your Exam

If You Go Low

  • Take your fast-acting glucose immediately

  • Use your rest break, if needed

  • Once back in range, eat a slow-release carb to stay steady

If You Go High

  • Drink plenty of water to help bring it down

  • If needed, correct with insulin- but be careful of stacking doses

  • If you feel awful (thirsty, blurry vision, headache) use your rest break and take a moment to recover.

If blood sugar seriously affects your performance, ask your exam officer about special consideration- you may be able to appeal for a mark adjustment.

Step 5: Revision & Study Tips Without Wrecking Your Blood Sugar

  • Keep to a Routine- Set a revision timetable and stick to normal mealtimes

  • Take Breaks to Avoid Burnout- Set a timer for 45-60 minutes of studying, then take a break

  • Keep Hypo Snacks Nearby- The last thing you need is a hypo mid-revision session

  • Watch for Late-Night Highs- Too much snacking during late-night cramming = overnight spikes. Try to stop eating at least 2 hours before bed

  • Get Moving- Even a short walk can help regulate blood sugar and clear your head

Final Thoughts: You’ve Got This!

Exams are tough, but you’re tougher. With the right planning, diabetes won’t get in the way of your A-Levels or University Exams.

  • Sort your accommodations early

  • Keep blood sugars steady with food, sleep and stress management

  • Pack everything you need for exam day

  • Use rest breaks and accommodations if you need them

You’re working hard, and that’s why matters most. Believe in yourself, prepare well and go smash those exams!

Amy Rouech
Previous

Keep Calm & Carb Smart: Best Exam Week Meals

Next

From Home to Halls: A Guide to Uni Life with T1D