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April 3, 2005

Behavior, Hypoglycemia

Question from Jacksonville, Alabama, USA:

I am 33 years old and have had type 1 for 30 years. I check my blood sugar on a normal schedule and go to my endocrinologist every three months. My last A1c was 5.4. At times, I am combative when I have a low blood sugar. My wife does not understand why I am this way. I refuse to take anything from her and am uncooperative. She fears that I will hurt our children or her. Can you please explain to my wife that I have very little control of myself when my sugar gets below 50 mg/dl [2.8 mmol/L]? She thinks that it is my personality. I do feel guilty for being low at times. Can you please explain to her, in writing, that all diabetics are different in how they react at certain stages of a low blood sugar? Any advice would be very helpful.


It is true that when patients develop severe hypoglycemia, they can become combative. It is often mistaken for aggressive action or a mean personality. Since glucose is the fuel for the brain, low sugars cause the brain to malfunction, often affecting the parts of the brain that are involved in moderating extreme behavior. I would also say to you that if this happens, you need a game plan for addressing it. You do not want to put your family at risk. Your best bet is work with your physician to avoid the lows that initiate this behavior in the first place. It is not enough to leave it to chance.