Finals week comes with enough pressure already. Between studying, deadlines, late nights, and changing routines, managing diabetes can feel like another responsibility competing for your attention.

But what happens if your blood sugar drops halfway through an exam? What if you need to check your continuous glucose monitor (CGM), take insulin, or step away to manage your glucose?

You shouldn't have to choose between taking care of your diabetes and doing your best academically.

That's why understanding your college accommodation rights matters, especially before finals arrive.

1. Diabetes accommodations don't automatically carry over to college

If you had a 504 Plan or Individualized Education Program (IEP) in high school, you might assume those accommodations automatically follow you to college.

They generally don't.

In college, students are typically responsible for contacting their school's Disability Services Office, disclosing their need for accommodations, and completing the required process.

The good news is that students with diabetes are protected against disability discrimination under federal laws, including the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act.

Eligible students can request reasonable accommodations that allow them to participate in their education on an equal basis.

And you don't have to wait until there's an emergency to begin.

2. What accommodations can students with diabetes request?

Diabetes management doesn't stop when an exam begins.

Depending on your individual needs and your school's assessment, possible accommodations may include:

  • Access to diabetes technology: Permission to use a CGM receiver, insulin pump, glucose meter, or other necessary diabetes equipment during an exam.
  • Access to food and drinks: Permission to keep fast-acting carbohydrates, snacks, or water available when medically needed.
  • Glucose management breaks: Time to check glucose, administer insulin, treat hypoglycemia, or manage diabetes equipment.
  • Testing adjustments: Appropriate breaks or other testing modifications when diabetes management interferes with an exam.
  • Classroom and laboratory accommodations: Arrangements that allow students to manage diabetes safely during academic activities.

Some students may also need accommodations involving housing, meal schedules, or diabetes-related medical absences.

Importantly, accommodations are individualized. Additional testing time, particular devices, or other adjustments are not automatically approved simply because a student has diabetes.

Your school's Disability Services Office can explain the documentation required and how requests are evaluated.

3. Why should you arrange accommodations before finals?

Imagine you're in the middle of an important exam and your CGM alerts you to a low glucose level.

You need to respond, but you're also worried about losing valuable exam time.

Having approved accommodations in place can help establish what should happen before that situation occurs.

Preparing early can also give you time to clarify which diabetes devices are permitted, what breaks are available, and how your professors will be notified.

And preparation isn't only about emergencies.

Finals season can affect sleep, stress, eating patterns, and physical activity. These changes may influence glucose management, even when you're following your usual care plan.

Planning ahead gives you more room to focus on your health and your studies.

4. How to request college diabetes accommodations

Step 1: Contact Disability Services.

Find your college's Disability Services Office or Accessibility Services Office. Ask about the registration process, documentation requirements, and deadlines for accommodations.

Step 2: Identify your diabetes-related needs.

Think through the situations that may interfere with exams, laboratories, classes, or campus life.

For example, do you need to use your phone to monitor a CGM? Do you need uninterrupted access to glucose treatment supplies? What should happen if hypoglycemia occurs during a timed examination?

Step 3: Gather the requested documentation.

Your college may request documentation from a qualified healthcare professional explaining your condition and why particular accommodations are needed.

Requirements vary by school, so confirm what is acceptable before requesting paperwork.

Step 4: Review the approved arrangements.

Once your request has been evaluated, clarify how each accommodation will work in practice. Confirm the process for communicating approved accommodations to professors and exam administrators.

Step 5: Prepare before finals week.

Don't assume an approval automatically covers every situation. If you're unsure how an arrangement will work during finals, contact Disability Services ahead of time.

If you've already reached finals season without accommodations, reach out anyway. Ask what options are available now and how to prepare for future exams.

5. How Balance Diabetes Wellness can help

You don't have to figure out every part of college diabetes management alone.

At Balance Diabetes Wellness, we understand that glucose management needs to work within your actual life, including exams, changing schedules, study sessions, and time away from home.

Brandy and our team can help students understand their diabetes-related needs, prepare for accommodations conversations, and work with appropriate healthcare professionals on supporting documentation where applicable.

We can also help students develop practical strategies for managing blood sugar during demanding school weeks.

That may include reviewing glucose patterns, planning manageable meals around class schedules, preparing for changes in sleep or activity, and identifying when additional coordination with the diabetes care team is needed.

The goal isn't to promise perfectly stable blood sugar throughout finals.

It's to help you enter exam week with more preparation, clearer options, and the support you need to manage your health.

6. Your health should be part of your finals plan

Preparing for finals involves more than reviewing notes and completing assignments.

For students with diabetes, it can also mean knowing how to access treatment supplies during exams, understanding what accommodations are available, and having a plan for unexpected glucose changes.

You deserve access to your education without being penalized for necessary diabetes care.

And asking for support doesn't mean you're less independent. It means you're taking an active role in protecting your health and advocating for your needs.

Steady blood sugars come from support and strategy, not punishment and restriction.

Need help preparing for finals with diabetes?

Balance Diabetes Wellness can help you build a practical diabetes management strategy and navigate conversations about the support you may need.

Contact BDW to schedule a consultation and learn how our team can help.

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This article provides general educational information about U.S. college accommodations and is not legal advice. Accommodation decisions depend on individual needs, applicable laws, and institutional procedures.