Question from Berea, Kentucky, USA:

My daughter, who has type 1 diabetes and uses a pump, has also been diagnosed with a severe anxiety disorder and trichotillomania and is on homebound schooling because of the anxiety disorder. She is rarely sick with viruses, colds or other illnesses which is good, but because of the anxiety her blood sugars are frequently out of control.

Anytime she becomes anxious or agitated about something, she begins a cycle of high blood sugars (250-600 mg/dl [13.9-33.3 mmol/L]) along with moderate to large ketones in the urine, nausea without vomiting, muscle pain and mild shortness of breath for several days. Usually during this time, we increase her basal rates and give large amounts of insulin with injections. However she ends up in the ER where they load her up on fluids and send her home only to go back and be admitted to the hospital and put on an insulin drip. Her endocrinologist says that even with the symptoms mentioned above, she is rarely acidotic and that’s why she is usually reluctant to admit her right away.

I am not questioning the endocrinologist, I trust her a great deal, but I am just wondering how common this problem is. Do you have any suggestions or insight? I guess I really just wanted a second opinion.