March 24, 2003
Behavior, Other Social Issues
Question from Saint Petersburg, Florida, USA:
I had a blow out last night with a friend regarding her nine year old daughter who was diagnosed with type 1 diabetes about two years ago. I don’t spend a lot of time with them, but when I do most times her daughter gets very whiny about this or that (in my opinion the normal bratty nine year old girl thing) and many times down right nasty, and when she does this, her mother automatically says that her sugar must be high or low and goes to check her. As a woman who goes through pretty severe hormonal mood swings each month and has learned to feel them coming on and to control my behavior, I find it very hard to believe that her daughter has absolutely no control over her actions, even when her sugar is low or high or whatever.
I told my friend I did not believe her daughter had no control and was informed that I had no idea what I was talking about. Even in defense of herself, she did not say that she has talked to her daughter about self control, and I have never heard her challenge her daughter to control her behavior. Granted, I am not around them that much and realize that complete self control comes with age, time and effort, but diabetes is always presented as an excuse for her behavior when I am around, and she has always had behavior problems, even before diagnosed with diabetes.
To give you more history, my friend never believed in “making” her daughter apologize for her actions, even when she was younger (pre-diagnosis) and clearly did something wrong (like pushing my son down). Perhaps she has always had sugar level swings and was always feeling the highs and lows. As a rational person, I just don’t understand it. If I am wrong in believing that the young lady should in some way be held accountable for her actions, please help me understand because the survival our friendship may depend on it. Is it true that a nine year old cannot be held accountable for behavior (whining, screaming and even being aggressive — pushing, scratching, spitting) when she is too low or too high?
Answer:
The simple answer to your question is this: Once any person’s (adult or child) blood sugars are below 70 mg/dl [3.9 mmol/L], the brain is not getting enough fuel (glucose) to function properly. During such times, many people have mood swings, become difficult to talk with or reason with, and are not able to learn or concentrate well. Some become aggressive. Most of the time, they have no recollection of their behavior once their blood sugars are normalized. Therefore, if anyone with diabetes (children, in particular) are behaving in an unusual way, they must have their sugars checked, and if low, then treated. If the sugars are above 70 mg/dl [3.9 mmol/L], then they are responsible for their behavior and should be disciplined accordingly. Very high numbers might make you feel lousy, but you are in control of your behavior.
The more complicated issue is that your friend and you have different parenting styles. That’s an issue you may or may not wish to discuss but is separate from diabetes.
JWB
