I am a school nurse at a Catholic private school, and I have one fifth grade student with type�1 diabetes who is on an insulin pump. His very knowledgeable about his diabetes, but when his blood glucose is low, he becomes very angry, mean, and nasty. He refuses to check his blood glucose and says he knows that its fine. I try to insist but this makes him even angrier. He is known to have very low blood glucose levels when he is like this. Do I have the right to physically check his blood glucose even if I have to have help restraining him? What do you suggest?

I would review your concerns with his parents and together come up with a solution. It is important to check the blood sugar when possible if you think a child is low, but in a pinch, it’s not necessary. You may have better success asking the parents how to change his insulin dosing or meals to decrease the frequency of the low blood sugars in the future.

MSB

[Editor’s comment: I agree with Dr Brown. This young man’s behavior during a hypoglycemic episode is very typical. The rule of thumb has always been, “when in doubt, treat”. Giving some quick-acting sugar won’t hurt anything, and you can check a blood sugar once he is himself again.

I would not physically restrain him. Having a blood glucose number is not all that important in the larger scope of things.

SS]