My nine year old daughter has had type�1 diabetes since she was eight months old. For the most part we have kept it under control, but recently we are running into problems. Her blood sugar levels are now up and down and harder to control. She has just recently become very emotional, and it does not seem to be related to low or high blood sugars. This can happen at anytime without any explanation. Could the fact that her levels are no longer under control be a factor? She has been a very happy child and has assured me that nothing has happened to make her feel this way. It is starting to bother her and frighten me. She can’t explain in detail how she feels but just that she is very sad for no reason.

Emotional ups and downs can occur at the beginning of puberty due to some hormonal changes. This is a wee bit early in a child your daughter’s age, but not so unusual these days. Is there any evidence for early breast changes or pubic hair or underarm odor? Is there a family history of early puberty in either parent? This would then also make sense as a possible explanation if there is no other psychosocial reason.

The ups and downs of sugars that occur with pubertal changes are likely from what is called insulin resistance. There is not much to be done about it since it is random, but usually it responds to increased testing and more detailed insulin and food changes. You should talk this over with your daughter’s diabetes team so that they can evaluate all the possibilities and also give you some specific advice.

SB