College accomodations

My son and I visited a college today. While we were there we spoke to the disability department head. Our question was "what is the college equivalent to a 504 plan like we had for high school."
My son did not like the answer. The 504 allowed him to finish a test or in class assignment at another time if he had a high or low bs event during the test. This guy said my son would have to take all tests in the disabilities office with "double time" to accommodate that request.

My son doesn't want to do that and is seriously considering not filling out the disability paper work and just emailing all of his professors to keep them informed.

I don't know what to tell him. Anyone out there who has attended college with type 1 willing to tell us about your experiences? What did you do about accommodations ?

Not sure I'll be much help. I spent 8 years in post secondary education back in the "bad old days" before they had these things. All I had my was medic alert and if I went low during an exam, I had a doc's note, my bracelet, and candies. I did fine. As for going high, I just slugged my way through and did ok. Maybe I was just lucky, but I think in the overall, we can do whatever we set our mind to with minimal help. Just a few things to make exams easier, cut back on drinking/partying/etc and things should be fine. Although I doubt they would allow something like a smart phone to track or calculate dosages. Wow, had a pump been available in those days that would have been great for me. Is your son pumping?

yes and he has good control and is a good kid. (no partying) although I know that can change when they get to college. He is inclined to tough it out too. He feels like the help will be a hindrance. I kind of hate for him not to have the protection but I suppose there is not that much protection for him in the non academic world. sigh.

I completed both my undergraduate and graduate education with no accommodations. I sought accommodations during my attendance in law school, where I took my exams in a room by myself so I could test my blood glucose at leisure; have access to restrooms, water, food, etc. without disturbing my classmates.

What issue does your son have with the school's proposed accommodation?

They want him to take all of his tests out of the classroom in the disability department office where he would be given extra time to take the tests in case he would have blood sugar issues. He has only had this happen a couple of times during testing and struggled through if he was almost done. Once or twice he has asked to go to nurses office and finish the test later when he really felt bad. The college does not seem open to that way of dealing with it.

My opinion is that it's not fair to expect the college to allow him to have access to an exam and then ask to take the test at another time. There is also the matter of his classmates to take into consideration. His asking to leave in the middle of an exam being taken with them could be a disruption and distracting. And if he were to take the exam at a completely different time than his classmates, the instructor would likely have to compose an entirely different exam for him.

I think their proposed accommodation is reasonable. The professors are not going to be able to do anything for him without his working with the disability office. I don't think he needs anything more than extended time on an exam to allow him to test and treat and then immediately resume his exam upon regaining his cognitive function.

Best of luck to your son!

You are no longer covered by the Individuals with Disabilities Act when you go to college but you are still protected from discrimination under Section 504. If your college (or it's students) receive federal funds then 504 applies even if the understanding and compliance varies. Part of the challenge is that under IDEA most schools comply with an Individual Education Plan (IEP) which essentially covers Section 504. In addition colleges must comply with the Americans with Disabilities Act.

A school should be proposing reasonable accommodations, not putative (punishing) accommodations. Some typical accommodations for colleges students with diabetes are here. Another good discussion of what kind of relationship and request you can and should make is here. In the end, if you have a "reasonable" accommodation request, particularly one already satisfied with minimal impact/cost in a public school no college would have grounds to deny your request.

I was a T1 college student nearly 30 years ago now. The 504 paperwork concept did not exist back then. I found the high-school environment to be pretty oppressive and inflexible, but college was a blast of fresh air in terms of my ability to control my diabetes on my terms instead of the school's terms.

It is true that in college your son will generally have more time between classes, and may want to specifically schedule his classes, so he can check bg/eat snack if necessary/do correction dose if necessary so filling out the paper work may not be so necessary. If done discretely and without making a big deal about it, it is very possible to check and correct bg either in class or by slipping out to the hall.

It is unfortunate that the disability office is so "binary" about how accomodations can be made. In college I found a lot of flexibility for accomodating rare/unusual events, much more than you have gotten in your answers so far.

E-mail to professor may not be the best solution (generally didn't exist for me 30 years ago even though I was involved in university computer systems a lot!). I would encourage that sitting up front and getting in the professor's/TA's face as a hard-working guy trying hard to learn every day, and who just happens to be diabetic, is the best way to set up any such relationship.

Thank you Brian. very helpful


I would encourage your son to fill out the paperwork and work with the Students with Disabilities Office. The best part about that is that he is covered by the school if a teacher or professor refuses to work with him during a high or low BS event. I graduated in 2008 and had accommodations. At the beginning of each semester, I would make an appointment with each professor and give them the letter from the Office of Student Disabilities. We would then have an adult conversation as to what that meant for me in their particular class. In my larger classes, over 200 students, I would take the tests separate or with a smaller group of students, allowing for additional time, if needed. In smaller classes, say 20 to 50 students, I would take the first test of the semester in the classroom and then share any concerns about that performance in the week post test. This way, we could evaluate on a regular basis my performance and get actual results.

Whether or not your son chooses to use the accommodations allowed to him per the school, he has them as additional tools in his arsenal. If he has questions, he always has a safe space to ask them without judgement. They can also change, update, and adjust his accommodations throughout his years at school to best fit his needs. (I walked in and had no clue what was available to me, so we discussed every possible option and if it was appropriate for my needs!)

Best of Luck!

I'm 32, but it took me a LONG time to get through college, so I'm not far out of date. LOL.

Dear Kid,

1. Don't live alone. Surround yourself with people you trust. Work harder to maintain the best control that you can. The implications of having a severe low can be much worse as an adult, and as a man, in particular. I was a girl, and I got away with a lot more than you can. The police/EMTs took me to the ER when I had severe lows. For young men, sometimes they take you to jail. Especially, if you ever take a swing at somebody. In my Midwestern town, sometimes diabetics die in jail from hypo. So, be careful.

2. Drinking can be dangerous for diabetics for many reasons that you might not have imagined. Drinking will cause your bg to get low, so consider decreasing your basal rates.

3. Chronic illness will probably, at some point, affect your grades. That is NOT the end of the world.

If you do much reading of the posts - you have prob noticed that there isn't a ton of knowledge about diabetes among civilian populations. Did you read Troy's post? ? If I had to do it all over again, I think I would encourage him to advocate for himself. Don't let the stupid college Disability Office tell him how this works. They don't know anything. You could send the college Disability Office a short email stating how you are planning to handle a 'low blood sugar during a test' event and what accommodation you think that they need to provide.

Also, if your bg gets low during a test, I suggest that you just take the 'hit.' You can't ask to retake the test once you've put eyes on it and if you can't control your bg well enough to avoid that event, then you should be more worried about #1 than grades.

If you find that you definitely may need accommodation, know that it is going to be much more difficult to explain your medical condition and any accommodation that you need, to a foreign doctorate of computer science than it was to a teacher in the public schools. I don't know what you do.

I once had a pretty intense partial seizure during a test. I couldn't even write my name on it until after it was over and my hand writing looked like a 7 year olds. I might have spelled my name wrong. I couldn't form sentences or thoughts well enough to speak when I handed in the test so I just went and got myself a pizza because my bg was 60. About 20 min. later, I returned to talk to the instructor. She had a doctorate in mathematics and she was Chinese, so there were already some major gaps in our being able to communicate, but in the end, she said, "You need rest," instead of saying, "You can retake the test tomorrow because you are obviously not in your right mind," like I hoped. I don't think you can pass a class with a 0% on a test, so I got a 'medical withdrawal', from the Disabilities Office, but I think they required me to withdraw from ALL my classes as a condition of taking it. THe policy was, I think, meant to accommodate 'major medical' events, like if someone got in a car accident and they were out of school for 2 months. That was bad news for me.

Once, I saw a girl pass out from hypoglycemia in a chemistry class. Luckily, she didn't spill any chemicals on herself. When I asked if anyone had any money for an orange juice from the vending machine downstairs, the professor got really irritated and said, "There are no beverages allowed in the lab!" So, we had to get her outside the lab and then the professor had a cow and said that she needed to go to the nurses office, even though she could barley walk. The professor got so disruptive in trying to take over that we never were able to get her an orange juice. But, she wasn't a diabetic and did regain consciousness, and the ability to stand, pretty quickly, so it all worked out. She was super embarrassed, but fine. My point, don't expect professors to advocate on your behalf. They are like everyone else, they don't know anything about diabetes and are no help in an actual emergency.

Hi Michele
Make sure to check out College Diabetes Network they have great resources concerning College life.
Me being in Switzerland i probably cannot give much information, I usually just informed my teachers so far, but for bigger tests i got a doctors letter to tell them i need to be able to do what i need to control my BG. so far i have managed not to get severe hypos during tests, i prefer to run high on big tests. But i have to say that switzerland is way less "formal" than the US, 504 plans do not exist here, we usually have conversations and so on. you actually just reminded me to schedule a date with the person at my uni who is responsible for this… thanks!
All the best to you and your son!

I went to college 25 years ago and never pursued any accommodations, but my control was lousy back then! I think it's a great idea to have accommodations paperwork in place in case of an urgent situation. Are 504 plans available to college students and adults? In my working life, I inform my HR team that I have Type 1 and that there may be situations where I need to duck out of a meeting or keep food at my desk, and I've never had to file any formal plan for that. But I work at a university, and while most of our instructors are happy to accommodate a medical situation informally, some won't be flexible without ADA paperwork, so it might be helpful to have it in place.


I am currently a freshmen in college (nursing major) who has accommodations through my university. I also have accommodations for extended testing times in the event of severe lows and highs, and my university also requires that I schedule a testing time and take the test in their office.

I have not had to use my accommodations yet, but I like having them as a safety net in the event that I know a specific class time is more likely to be filled with lows/highs. If I am unable to solve some basal issues with one class (a three-hour lab in the evenings once a week), I might use the testing accommodations for the next exam.

My accommodations also contain some requests more specific to my major. As a nursing student, no jewelry of any kind (except stud-post earrings and sometimes wedding rings) is allowed, and I have an accommodation that allows me to wear medical ID at all times. I also have defined within my accommodations that all diabetes-related absences should be considered as excused absences, and I am allowed to have diabetes supplies, food, and drink on me at all times. In regards to scheduling, I also have in my accommodations that I should have at least one half-hour break during the day in order to eat and correct out-of-target BG's, and, in order to achieve this, should be granted priority registration (priority registration was recommended by my local JDRF after horror stories of diabetics going low while standing in line waiting to physically register).

I hate to say it, but most professors and colleges do not care about why someone was unable to meet a deadline, especially with turning in assignments. Not meeting a deadline because of laziness and not meeting a deadline because of staying up all night the night before treating ketones ultimately results in the deadline not being met. It is best to get major assignments, especially when professors give ample time, done as soon as possible in order to prevent situations where an emergency pops up right before the deadline and causes you to not complete the assignment. Life is unfair, and he is going to be dealing with that a lot at college.

One of the things that has helped was introducing myself to the professors at the beginning of the semester, saying that I am diabetic, and asking whether or not they are alright with me testing my BG during a lecture. I also tried to have at least one person in each of my classes know that I am diabetic (though I should have also told them that I keep glucagon with me for severe low BG's).

If he is really afraid of going low during an exam, and he is using a pump, could he reduce his basal a few hours before the exam and let his BG run a little bit high? Ultimately, being a little high for a short duration will have less of an effect than going into hypoglycemia when he is expected to perform an important task.

Unfortunately, I do not know much about accommodations for housing. I am currently a commuter student with no interest in living on campus.

I did ok at college, although I had a few serious hypos, often the morning after wild benders. I wouldn't consider retaking a test b/c of a high and, generally, I am able to treat lows in a reasonable amount of time to cover a test. I don't find either of them that debilitating that I would prefer to say "I need to go take the test in disabled office". Not that there's anything wrong with it if you need it but I had pretty much everything I needed to treat lows or highs along with me in my briefcase when I was in college. I was Liberal Arts though, so maybe it would be different if I'd been in a grindier major like electrical engineering or chemistry.

I don't think it ever came up with any professors either. Professors are probably not going to care about your excuses, they care about your work. This is good and bad but it's not like high school. Even if you're protected, it sounds like this school has sort of tossed down a gauntlet to say "you can have your disability if you accept our crappy conditions...". I would pick up the gauntlet and hit them with it.

If the 6.0 A1C on your page is accurate, your son and you are doing an excellent job. Controlling diabetes. I would think fine-tuning things to cover tests should be manageable at that level of control. Another idea might be to try a CGM and see how that might help. It's an added cost and can have some inconvenience but it can make it much easier to anticipate highs and lows and manage them in real time so they don't get in the way of things.