Besides trying to set in motion a 504 plan, I told my son to TELL me the next time before he has an honors Chemistry test or a Latin 4 test. Chemistry is making his blood sugar go way high and Latin holds that potential. I said that perhaps there was some kind of logic in adjusting the carb ratio for his insulin at lunch on days he has one of those tests (those classes are the last two of the school day). Keeping in mind that he is MDI and NOT pump and recognizing that I would never substitute this list for doctor's advice (blah, blah, blah), how have other high school students or previous high school students handled high blood sugar induced by taking tests? Any advice?
stress can increase insulin resistance by over 100%. It's probably not a good idea to overdose (change carb or correction ratios) because you think you are going to be stressed., only because it could get you in trouble with a bad low, or if the stress level somehow changes (test was canceled, etc.)
I would try address the stress. Repetition, preparation, or training can be good therapy for test stress. Read about performers, and how they overcome their stage fright, or what they can do to reduce it as I believe it is just a state of mind.
If the stress is coming from not "feeling" prepared it's a mind game. If the stress is coming from not being prepared then maybe a new school strategy could help.
IMO I would eat a low carb, higher protien/fat meal before a test (something that would only require a little insulin). I would keep my insulin the same, I would also test and correct if necessary about 1 hour after the test.
I am a junior in high school and when my sugars are high on tests, I normally take them anyways unless I am extremely unable to do so. My parents also email the teachers and ask them that if I am acting funny, that they would ask me if I am okay. I would only argue if I am high or low and don't score like I normally would, and in that case I would want a retake. I do NOT have a 504 plan, but have a general diabetes care plan.
Besides being prepared or trying to relax like Joe said, I can only think of testing frequently the day of the test to prevent a high as it happens. Maybe don't respond until 200, and try to drink water instead of opting for insulin. I frequently develop high sugars before a test no matter what, and quickly drop after it is over, so have some sugar with you just in case.
Joe offers some great advice in regards to helping your son out. The other thing you can always do is talk to your sons doctor for ideas. But again on days of big tests the balance of protein and low carb could be very good, not to mention get the brain juices flowing and ready to go. Even the small steps help.