March 30, 2003
School and Daycare
Question from England:
Our eight year old daughter was diagnosed with type 1 diabetes two months ago. She has Insulatard and Actrapid in the morning and Insulatard at teatime. Her blood sugars vary a lot, and at school she has always been at the top of her class. However, since she has been diagnosed, the teacher comments that my daughter often struggles to concentrate. If they then ask her to do a blood sugar the results are always over 20 mmol/L [360 mg/dl]. Sometimes she hasn’t finished her packed lunch as she says her sugars were high, and she can’t think straight. Her doctor says that high blood sugar does not affect concentration and academic performance as there is no research to show this. I am worried that her sugars are too high in the day and that she is finding studying more difficult as a result. Do high blood sugars affect concentration and/or mood?
Answer:
There are several possible causes for your daughter’s symptoms, but I am not convinced they are related to hyperglycemia. Difficulties in concentration and mood are more likely caused by hypoglycemia. Rebound due to the two insulins injected at breakfast may explain the high blood sugar following hypoglycemia. Furthermore, I have seen these concentration and/or mood symptoms in patients who have high as well low blood sugar levels especially in younger children who will often have difficulties in discerning the two, mainly when hypoglycemia unawareness is present.
Ask teachers to check her blood sugar level, if possible, right at the onset of the symptoms she reports.
MS
