Our 15-yr-old daughter (diagnosed at age 6) has testing accommodations for school and PSAT/SAT/etc. exams (she is allowed to have her devices with her to monitor her BG, and if she is out of range, the clock is to stop until she is back in range), but she has never used them. She simply ignores her BG and continues with testing regardless of highs or lows. She will fix a bad low (under 65 probably, under 55 almost always, but even then I’ve seen her wait to finish whatever she’s doing first), and she’ll ignore highs no matter how high. She says her BG being out of range “doesn’t matter” for how she performs on tests. I suspect she really just doesn’t want to be different, which is completely understandable. Nevertheless, does anyone have any suggestions for encouraging her to actively manage her BG — not just in general, though that, too — but especially when testing, and even more especially during high-stakes testing?
Hi @srozelle Susan, your daughter is doing pretty much exactly what I would do, and pretty much exactly what I do now, so I don’t have anything to give you to make her do things closer to the way you want them done. My current job function is critical thinking and problem solving in a technical field and in engineering design. I can be successful at any blood sugar above about 55 on my CGM.
My advice as a parent is to reinforce that accommodations are there for her support, so she should not forget about them as a general safety net. I might be inclined to have a conversation, just to make sure you say it, and she hears it. My opinion is that you got a spirited, smart kid and she feels she is taking care of herself. Good luck!
Speaking as a teenager (also 16) so feel free to disregard some of what I’m about to say- as long as your daughter is managing her blood sugars, and not going dangerously high or low, and she feels confident that she can do well on the test (and test results don’t show otherwise) I’d let her be.
As long as she feels fine and capable and isn’t failing the tests or super symptomatic, let her do her thing. Like Joe said- we live with this disease for the rest of our lives, or at least for the foreseeable future, and we just can’t take time outs every time our blood sugar is over 250. Life doesn’t stop. Yes we need to take breaks, yes we need to treat ourselves according to the numbers on our cgms/meters, but at some point we do just need to push through it.
You are the parent- if you think your daughter is putting herself in danger by not treating or taking care of herself, or just making bad choices, then you should talk to her and try to persuade her to do otherwise. You know your daughter best. But also remember that at some point she is the one who’s going to have to take charge and decide if she’s going to use the accommodations or not- you can’t always decide for her or make her do things.
Also with every college board (AP and PSAT) test I’ve taken I’ve been put in a separate room with my “private” proctor so that I don’t distract anyone else in the testing space (I don’t agree with that logic but I’ve actually really liked it because I find that even with breaks, I finish sooner than the rest of the group and it cuts down the distractions for me). If you think your daughter is feeling some sort of peer pressure not to stop and test/treat, then maybe you could ask for a private testing space if you think that would help.
Good luck to your daughter on her tests!
Thanks to you both for the wise words, and I am 100% on board, except…. Her test scores do not accurately reflect her ability, and I thought being out of range makes critical thinking, good judgment, stress management— all the things required to test well — harder. Not true?
Hi Susan @srozelle, it is good to see you back here after a couple of years; I’ve missed the wisdom you always shared, and “S” has certainly grown up.
Like Lise and Joe have said. your daughter could be the best judge to know the range in which she can effectively operate, but I’ll add the caution, from my experience, that going too low may influence her to take added risk. Suggest, please, that she have with her some quick-acting carb. When I proctored, in day-gone-by, I permitted carbs - nothing else - to be placed openly on the desk surface.
I’m the opposite of @joe- being high definitely messes up my brain, but I’m unaware of my lows most of the time.
I’m very motivated to take care of my highs because I start talking funny when I’m high and school work becomes impossible due to blurred vision- but I’m not sure if your daughter cares or if she experiences those symptoms.
I still think that a separate testing environment could help if you think it’s peer pressure related, and otherwise you can only try to persuade her that her BG is messing up her scores and to take the extra time. She’s going to have to make the choice to manage her bgs.
I wish I had more suggestions 
I appreciate all this this, thank you. Her endo’s office just shared a link to some research studies confirming what you knew already: cognition is impaired when out of range, but the details depend on the individual (Relationships Between Hyperglycemia and Cognitive Performance Among Adults With Type 1 and Type 2 Diabetes | Diabetes Care | American Diabetes Association)
And yes, very much on board with this being hers to navigate. We’re just doing what we can to send her out into the ocean well-equipped. 
Some people simply are better at testing than others - for some people the anxiety about how they will score causes then to freeze up, even though they can quote the facts and otherwise demonstrate understanding of the material.
If there’s a definite correlation between her numbers and her test scores, showing her the facts might help; but if not it sounds like she’s okay doing what she’s doing.
Maybe the thing to do would be to find a good profile to use for testing situations to avoid the extremes?
I agree with everything Lise has said. And I think Dorie’s advice about helping your daughter learn to avoid the extremes in the first place is worth following. I had similar accommodations - sometimes with a separate testing room, sometimes not - when I was a teenager and I barely used them. Most often because I didn’t need them, but occasionally because of embarrassment or stubbornness (and I can share a couple cautionary tales from elementary school if you want them). But later, as an adult and taking exams for professional certifications, those accommodations were often denied. So knowing my personal limits and then having a plan to stay within those limits during testing was really important.