Information for Young People with Diabetes Mellitus

 Anxiety and Preparing

Diabetes adds an entire new level of anxiety to exams. To perform at your best cognitively, you will need to have close to normal blood glucose levels. When the BGL is too high you may be thirsty, tired, have difficulty concentrating and may need to go to the toilet a lot. When the BGL is too low, you will have trouble concentrating and may become confused. Stress can also affect your blood glucose levels however this is very individual i.e. some people go very high and others experience low levels. It really is worth making the extra effort to try and get the BGL’s under control before exam time starts. Some students with diabetes trial different approaches to management around the “mock exam” period to try and ascertain what will be the best approach to control blood glucose levels around the actual exams. Your Diabetes team will be able to support you with this so do talk to them about exams and exam planning well before your final exams are scheduled. 

Diabetes Food

It is imperative that you have access to “quiet hypo food” (such as sucking sweets or juice and fruit bars rather than crunchy crisps), your blood glucose testing equipment and insulin administration equipment during exams. School personnel supervising the exam need to know in advance that you have Type 1 diabetes and that you may need to carry out a blood test, eat, administer a dose of insulin or go to the toilet during the exam. 

Rest Breaks

NZQA prefer schools to advance apply for formal “Rest Breaks” for all young people with diabetes during exams. A “Rest Break” is defined as when a student can put up their hand to indicate to the supervisor they are starting the break, then they can do their blood testing, eat and drink if they want to, and then indicate to the supervisor that they are ready to start writing again. The supervisor notes the time taken, and adds it to the end of the exam session so that the student doesn't lose writing time for the medical necessity (usually this is no longer than 30 minutes in total). 

Students with diabetes do not generally get separate accommodation for the exam, but are usually preferably seated in the corner or the back of the room so the supervisor knows where they are and the student does not disturb others in the event of medical necessity. 

Most schools have good systems in place for students with diabetes, but as NZQA Exam Supervisors are not generally on the school staff, NZQA prefer that schools have it as a formal entitlement so that it is on the Exam Centre Manager's schedule to warn the supervisors that a student with diabetes is present.

Special Assessment Condition Assessment Application and Medical Certificate

It is strongly recommended that students with diabetes ask their Dean, school guidance person, school nurse, special needs coordinator etc to make sure that they are included in the advance submission of Special Assessment Conditions applications (always submitted by schools to NZQA in Term 1). Students need to provide the school with a Medical Report/Certificate which provides evidence of the functional impact of diabetes and details clearly how the candidate’s access to assessment may be impaired by the diabetes inclusive of specific recommendations for suitable examination conditions. Your diabetes team need to provide you with this report at the beginning of each school year. You can request this when you attend your clinic review. The signed medical report then needs to be submitted to NZQA together with the Special Assessment Conditions application. Generally schools take care of the submission on your behalf once you have provided the medical certificate to the relevant school personnel (school nurse, dean, SENCO etc). 

This is the link to the Special Assessment Conditions section on the NZQA website. 

If by any chance there was a serious problem and a student was unable to complete the exam, then the “Derived Grade Procedure” under the “illness and misadventure” clause can be considered. Derived grade is to be given to students who have been clearly disadvantaged due to diabetes related events (for example hypoglycaemia or significant hyperglycaemia during the exam. The formal process around this is outlined on the following website link: 


It is strongly suggested that at the beginning of each exam year students with diabetes organise a meeting with the Special Needs Coordinator (SENCO), School nurse, Dean and anybody else who may be able to support with putting into place support frameworks and understanding expectations around the exams and diabetes.

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Resources to help with Exam Stress and Anxiety

Click the icons below to access each resource



ReachOut Breathe

ReachOut Breathe

Smiling Mind

Smiling Mind



The Check-In

The Check-In


NZQA Medical Reports