March 4, 2010
Behavior, Hyperglycemia and DKA
Question from Johnsburg, Illinois, USA:
Now 12, my son has had diabetes for seven years. All his teachers have commented on how bright he is, but he had behavioral issues at school between the ages 8 and 11. He is in a special needs class with a smaller class size and that has helped greatly this year. He has made the B honors two quarters running and had no issues at school. However, he has begun to do damage to our home over the last three months when he is being disciplined. He has locked himself in the bathroom and broken a sink and damaged the walls with a screwdriver. We tried some positive reinforcement and painted his room. Last week, his 15-year-old brother kicked him off the couch so he went upstairs and took model paint and painted graffiti all over his brother’s room. It is on the ceiling, bed, walls, shades, dressers and carpet. We punished him for two weeks and he just recently got over that punishment. When I went to school for his teacher conference, they, once again, informed me how well he had been doing. Trying to give him some positive reinforcement, I took him out for his favorite dinner. He failed to wake up in time for school today so he was punished one day for missing the bus. When he got home, he wanted to go over to his friend’s house and my wife reminded him he was punished. He proceeded to take a knife and poke holes in my kitchen wall. He then went upstairs and locked himself in the bathroom and poked holes in the drywall. I love my son, but I am afraid he is going to hurt someone or himself if we don’t get help. When we tested him today he was very high, 534 mg/dl [29.7 mmol/L] and I think that may have something to do with it. I’m not so sure how high his blood sugar was previously when he did the other damage. Does the high blood sugar cause rage or could it be something else? He hasn’t acted out because of the diabetes before and has seemed to handle it quite well. He has gone on Boy Scout trips and has been very good. Is this him just reaching his teen years or have there been other cases of such rage? Our doctor says they can’t put him on the pump until he reaches a more level plateau but I feel that the pump may help him with these highs and lows. Any advice would be helpful.
It is unlikely that your son’s behavioral outbursts have anything to do with diabetes. It is unlikely that an insulin pump will have any impact on his behaviors. Some of his behaviors (a knife damaging property) are extremely dangerous. Please seek a psychological or psychiatric evaluation for your son as soon as possible. Your pediatrician may have therapists he/she recommends. You may also wish to contact members of your diabetes team for advice.