May 21, 2004
Behavior, Blood Tests and Insulin Injections
Question from Downey, California, USA:
My ten year old daughter was diagnosed three months ago with type 1 diabetes. She is under pretty tight control, but the school called me recently concerned about her frequent testing, sometimes as many as seven times during the school day. In the beginning, it was because she felt low, and usually was. Recently, however, her blood sugars have been normal if not a bit high due to it being very soon after a meal. She usually complains that she has a headache or stomach ache and needs to go test. They are concerned, as am I. I was diagnosed around her age with OCD (Obsessive Compulsive Disorder) and have taken Zoloft for over a decade. I also have panic disorder. Could this be her problem as well? Should I consult her diabetes team? I just hate having to have her deal with anything else this soon after such a diagnosis. I know she is concerned and has read about the complications of her condition. I try to reassure her that things are different now and that we are controlling it so she won’t likely face the complications she is worried about. Have you ever heard of anything like this before? Are headaches common with diabetes or might she be OCD?
Answer:
Your daughter’s behaviors may merely be a result of her recent experiences with frequent low blood sugars. Those feel awful, and it makes sense that she would like to guard against those feelings. Her behaviors may also be a result of increased anxiety around blood sugar numbers. Finally, they could be a result of compulsive behaviors that have just begun to show themselves, in response to anxiety. Your experience with anxiety and OCD does increase your daughter’s risk for developing these difficulties.
Listing out all of the possibilities for why she is checking her blood sugars more frequently may not be the most helpful thing to do right now. Instead, it may be more helpful to ask her about these behaviors directly. She may have a simple answer, and then you can help her with a simple solution. If instead, she lets you know that she is, indeed, suffering from anxiety and/or compulsions, it will be very important that you contact a mental health professional who can work with her on these symptoms. The sooner she receives an appropriate evaluation and appropriate treatment, the sooner she will feel better.
JWB
