My son has been in ICU since September 11, 2008 for ketoacidosis. For approximately two years, he has had severe mood swings, from being a sweetheart to being a foul talking monster. He see’s a psychologist who says he has ADHD. Can some of these swings be from diabetes? He was just diagnosed on September 11 and, of course, is not under control yet. Can you point us in a direction of understanding?

Unfortunately, it is unlikely any of the emotional and psychological issues you are discussing are related to diabetes or pre-diabetes. High and low blood glucose swings have an impact on these issues, but not to this extent. It sounds more like Tourette’s syndrome or some bipolar disorder, so I would encourage working closely with psychiatry and psychology services to try to answer these questions. You also will need to work closely with your diabetes team so that all these specialists coordinate their care and recommendations. Many such youngsters will respond very nicely to medications or combinations of medications to control the ADHD and/or other emotional swings that you are describing. You will have to provide a great deal of direct adult/parental supervision to make sure that the glucose testing is accurate and recorded all the time, insulin is given appropriately and meal planning is balanced to provide optimal diabetes care and control as well. Giving too much responsibility to kids too early is one of the dangers to avoid particularly when there is also some other psychosocial issue co-existing.

SB