My son has started junior high, 7th grade, and recently had an outburst in the nurse’s office that was not appropriate. He was stomping his feet and hitting the wall. He did have an elevated blood sugar of 339 mg/dl [18.8 mmol/L], but had been low, 60 mg/dl [3.3 mmol/L] three to four hours earlier. It has been a struggle to regulate him again since school started. He was having trouble with some kids in science class teasing him, but when he saw that high blood sugar, it was described to me like the straw that broke the camel’s back and I was called into school. He has always been sensitive and does not hold things in, but would the hyperglycemia cause the behavior to escalate? Would his behavior be related to the highs and lows he had during the first week of school?

The high blood sugar itself would not be a cause of his emotional distress or outburst. However, his emotional reaction can certainly be a result of frustration and feeling overwhelmed with how difficult managing diabetes can be. Your son’s reaction is a strong indication that diabetes is overwhelming right now and he may feel that he cannot control his numbers, no matter how hard he tries. This can lead people to feel angry and sad. Please let your son know that diabetes can be very difficult sometimes and that everyone has times when nothing seems to go right. Also, please contact your diabetes team for recommendations for a mental health professional who may be able to talk with your son and help him learn strategies for managing diabetes as well as teasing and the pressures of junior high.

JWB
Additional comments from Barb Schreiner, diabetes nurse specialist:

It seems to me that several compounding stressors came together for your son. It is likely that the wide fluctuations in blood glucose levels contributed as did the teasing and the overall stress of starting back to school. It may be difficult to sort out each of these factors, but valuable to begin to address each: adjusting insulin for blood sugar control, exploring skills in handling the teasing, and using stress management strategies when angry or frustrated.

BS