My 10 year old son has had type�1 diabetes since age six, and since then he has problems in school. His blood sugars rise and fall all day long, and we have not had much success stabilizing them. He can go from 400 mg/dl [mmol/L] to 40 mg/dl [22.2 to 2.2 mmol/L] in a matter of hours. This has definitely has affected his schoolwork, and I do not feel he has ADD as the school suggests, because in controlled situations, such as pitching a baseball game, his concentration and focus are incredible. He is attending parochial school and they want me to pay for a private tutor which I unable to afford (let alone an insulin pump, as the school nurse has suggested). His physicians and dietitian have insisted on a strict carb counting diet, which will supposedly solve all of our problems, but this 10 year old boy will not cooperate. Advice, legal, medical or otherwise is greatly appreciated.

There are no easy answers to your problems. Carbohydrate counting will help, but not solve all of your problems. Most frequently, you will have better success controlling blood sugars by communicating regularly with your diabetes team.

Keep good records, test at least four times a day, and review these blood sugars with a professional on your diabetes team weekly (or at whatever interval your diabetes team suggests). Hopefully, this will result in dosing of insulin that will better meet your son’s needs. An insulin pump may also be a good option if it is financially feasible for you. The insulin pump companies (MiniMed, Disetronic, and Animas) have programs designed to help folks who have financial need. I would apply for these if this interests you.

MSB

[Editor’s comment: It seems to me that your son is in need of professional counseling to sort out what the issues are. It is interesting that his problems seem to only at school. There may be some stressors there that are causing the labile blood sugars, and the diabetes itself isn’t the culprit. I would ask you diabetes teams for a referral to a mental health specialist experienced with children and diabetes to help you and your son get the bottom of this.

SS]