October 25, 2001
Behavior, Daily Care
Question from Bluff City, Tennessee, USA:
We chaperone a high school band and have one child who is 15 and wears an insulin pump. She is able to do on the spot glucose checks, but is very attention-seeking and frequently gives misleading information in order to receive sweets. She does not follow a proper diet. There is practically no parental involvement, and her physician has submitted very vague information to us. What should be do for first aid for hyperglycemia and hypoglycemia? In the past, she has said she feels nauseated, and she is immediately given chocolate by the lead chaperone, and she will tell them 15 to 20 minutes later that her glucose is in the 400s mg/dl [22.2mmol/L].
I realize that glucose readings should always be observed by the staff, but I always learned that orange juice or hard candy were most appropriate for hypoglycemia. We are really unsure of what to do for hyperglycemia. Can you help us? Thanks in advance!
Answer:
You are in a difficult situation. It is difficult to fix a situation when the parents are not helpful. I would make sure to voice your concerns to the parents and principal. Also, you can find detailed information on the treatment of hypo and hyperglycemia on this site. I would encourage you to closely monitor her when she is complaining of symptoms of having a low blood sugar, making sure to see the meter reading when she’s testing would also be appropriate. Offering positive advice and positive reinforcement for good behaviors is important. All too often, the behaviors are an attention getting maneuver, especially when there is a poor social environment–and offering positive reinforcement for good behavior can go a long way to fixing the poor behavior.
MSB
[Editor’s comment: See: Acute Emergencies of Diabetes.
SS]
