My seven year old son, diagnosed 15 months ago with type�1 diabetes, is in the first grade and sometimes acts out in school. My son says from time to time, with regard to his behavior, “I can’t take it”, or “I couldn’t stop myself”. We are currently working with school teams, and he is receiving professional counseling. His principal and teacher are of the opinion that he may have ADHD, so we’ve scheduled an appointment with a specialist to investigate this possibility. He is a straight A student (I’m so proud of him) and able to concentrate on school work. At home, he can be a handful, but no more than I would expect from a seven year old.

We have not been able to control his blood sugars which range from 40 to over 400 mg/dl [mmol/L] routinely. His hemoglobin A1c at diagnosis was 7.9% and has been rising ever since with his latest being 8.8%. I told his principal and teacher that uncontrolled blood sugars could be why he is having a difficult time controlling feelings, outbursts, etc. They asked if I could supply them with research/data saying that diabetes can have an effect on behaviors even if numbers are normal at the time, not to mention when they are out of range. The teacher said this would help her approach the situations differently. Please educate me and school personnel about diabetes and unwanted behaviors of young kids.

You are correct that high blood sugars and low blood sugars can dramatically affect behavior. However, it would be an error to blame acting out by a seven year old just on his diabetes. Most seven year olds have time of acting out and problems with impulse control. If your son’s problems are more than the average seven year old, I agree that referral to someone with experience in pediatric behavior management is in order.

MSB

[Editor’s comment: I agree with everything Dr Brown has said, but have a couple of additional thoughts:

What does his counsellor say about all of this? I assume that he/she took part in the decision to have your son evaluated for ADHD.
Your son’s behavior may be related to anger about having diabetes, feeling different, etc. His counsellor should have a handle on this if he/she is experienced in the care of children with diabetes.
Have you checked blood sugars during these episodes to see if there is a relationship between your son’s behavior and blood glucose levels?
Your son’s blood sugars should not be fluctuating so much. It seems like he needs a change in treatment plans because the wide swings you describe should not be happening routinely.

I suggest you address the questions I’ve raised by:

Asking these same questions.
Doing some investigating to see if your son’s behavior is related to his blood sugars.
Getting your son’s blood sugars more stable. If he is not being followed a team of professionals experienced in the care of children with diabetes, ask for a referral.
SS]