November 24, 2009
Behavior, Hyperglycemia and DKA
Question from Knoxville, Tennessee:
Now five, my daughter was diagnosed with type 1 at 22 months. She has always been a strong willed child but, within the past couple of years, her behavior has become outrageous. She has become defiant, rebellious, devious, and, at times, violent. Yes, most times these are related to a high blood glucose (low blood glucoses are usually just weepy and wobbly) and we address it appropriately, but we are out of ideas about how to address these behavioral issues. It is exhausting and leaves the entire family in a state of complete chaos and discord. We thought that putting her in kindergarten would help, but, alas, they are not appropriately equipped to handle her erratic blood glucoses (despite the 504) and her behavior has worsened when at home. Now we are considering removing her from school and home schooling. How do we get the behaviors under control? How do we discipline and get her to begin learning to control her behavior even when her blood glucose is over 200 mg/dl [11.1 mmol/L]? We are out of ideas and out of patience.
Answer:
The behaviors you describe are unlikely to be primarily due to higher blood sugars, although that may be a portion of it. Even when a child feels awful with higher numbers, they are capable of controlling their behavior (not so with lows, when people are not in control of what they do). Please talk with your diabetes team and your pediatrician and seek referrals to a psychologist with expertise in working with oppositional behaviors in pre-schoolers. Working closely with an expert in that area should help you gain control over your daughter’s behaviors.
JWB
