December 30, 2003
Behavior
Question from St. Catharines, Ontario, Canada:
My boyfriend has had type 1 diabetes for approximately 17 years. Over the past months years he’s had lows at least twice a day. When it happens his mood completely changes. He either becomes confused, disorientated and angry or he becomes very sarcastic and rude. His lows are usually followed by highs. He tries really hard to control them. He’s been seeing his doctors regularly and is trying to change his insulin dosages according to his doctors instructions. He follows a diet and always counts his carbohydrates but nothing seems to work. He’s at a loss and is very frustrated. He will be switching over to an insulin pump as soon as the insurance clears it. He is currently on Novorapid before meals and takes 26 units of NPH before bed. I was hoping that you could give me some insight as to what might be causing this because he does not like discussing his health with me and I am not sure he’s telling me everything. He’s trying to keep it under control so people don’t need to know about it. It’s been a long time. Should he not have accepted by now?
Is it normal for a young person (he’s 19) to have a hard time discussing their diabetes? It’s almost like he’s ashamed of it. He tries to hide it from people but it is becoming increasingly difficult. He won’t even say the word and gets offended when people ask him about it.
Answer:
Your comments are familiar ones. It is common for people with diabetes to have emotional lability wit rapid swings in their blood sugar. As you suggest, the key is to prevent them. I am happy to hear he continues to pursue this with his physician. The fact that the behavior is directed at you should be motivation for him to try to do everything he can to prevent this. Going on an insulin pump requires an investment in his care, but it also the opportunity for great rewards. One of the rewards is better control and less behavioral symptoms.
I have to say that it is very common for people not to want to discuss diabetes with others. I think it makes people with diabetes feel vulnerable toward other people. However, those who want to hide that they have diabetes promote several behaviors that might be dangerous. For instance, if they begin to act differently, as with a hypoglycemic reaction, how will people know when to help them obtain glucose. Those individuals that have demonstrated this behavior tend to have poorer control. They are probably the ones that will not obtain an additional blood sugar because they are in public or in a vulnerable situation. That may lead to more lows or more highs that go untreated. I would hope that people with diabetes do not feel ashamed to let friends know they have this problem. It is a matter of trust for all concerned.
JTL
