The Department of Education should issue all schools with clear guidelines on how to accommodate children with diabetes during exam time, a new study recommends.

This year's Junior and Leaving Certificate examinations are just weeks away, but according to researchers at Temple Street Children's Hospital in Dublin, little is known about the experience of teenagers with type 1 diabetes during their Junior Certificate exams. They decided to investigate this further.

Type 1 diabetes is an autoimmune condition, not related to weight or a sedentary lifestyle. It cannot be prevented or reversed and is most commonly diagnosed in children under five years of age.

Currently in Ireland, all students with chronic conditions that may affect their performance in exams, including type 1 diabetes, can apply for ‘reasonable accommodations' to be made.

"The purpose of these is to lessen the impact of the condition on their performance, while ensuring that the child is not given an unfair advantage over other candidates. Specifically, a child with type 1 diabetes in Ireland can apply for multiple short rest breaks during each examination. The total of these rest periods cannot exceed 20 minutes," the researchers noted.

These breaks can be used, for example, to check blood sugar levels.

However, anyone wanting to avail of this must apply in advance, therefore affected students need to be informed about this facility early in the academic year.

The study found that just over one in four Junior Cert students with type 1 diabetes availed of this facility, however almost half felt that diabetes had affected their performance in the exams.

Reasons given for this included hypoglycaemia (low blood sugar) affecting the students' concentration, diabetes adding to the stress of the exams and general concerns about unstable sugar levels.

The researchers warned students that on the day of an exam, they ‘should be prepared for a possible stress-related increase in insulin requirement'.

The study also found that almost half of students did not bring a glucometer into the exam. This is a medical device used to measure the concentration of glucose in the blood.

At least one in 10 students also failed to bring a hypoglycaemia remedy into the exam, such as a sugary drink.

The researchers believe that the options open to students with type 1 diabetes at exam time must be discussed with them and their parents at the start of the academic year.

"Parents should be informed of the special accommodations available to their children at the exam and should also be encouraged to discuss this with their child's school prior to the examination. A plan should be in place for the day of the exam, where a checklist is provided for the adolescent outlining the equipment that should be brought into the examination centre," they insisted.

They also believe that the Department of Education should provide schools with clear guidelines on this issue.

Furthermore, invigilators in exam halls where pupils with diabetes are present should have a ‘basic understanding of the common diabetes related self-care procedures that may be required during the examination'.

If these steps were taken, they could reduce the number of students with type 1 diabetes who feel that the condition impacts negatively on their exam performance, the researchers added.

Details of these findings are published in the Irish Medical Journal.