We have a fourth grade student with diabetes whose mother says that school work, tests and homework can affect his diabetes by causing stress, and he can’t concentrate on homework for more than 15 minutes at a time. She states that if he is placed in detention hall, he needs to be able to walk around so that he can exercise to control his diabetes. I must admit I was unaware how much diabetes can affect school work. Am I getting false information?

It is true that fluctuating blood glucose levels can impact a child’s ability to concentrate and lean, but I think this mother could be using her son’s diabetes as an excuse for poor performance in school. Most children are perfectly able to deal with the stress of school work, tests and homework the vast majority of the time without time limits.

It appears to me that this child needs an evaluation. I suggest that you meet with this mother and develop a plan to deal with his school problems. It would be important to include your school nurse, your school psychologist or counsellor, and a member of this child’s diabetes team if possible. Please be sure that his diabetes is in reasonable control, prior to any testing that might be recommended.

SS
Additional comments from Dr. Jill Weissberg-Benchell:

Although a child’s ability to concentrate can be affected by low blood sugars (60 mg/dl [3.3 mmol/L]or lower), the behavior you describe does not sound like it has anything to do with daily fluctuations in his blood sugars. That said, children with diabetes are at increased risk for learning disabilities. Therefore, I would recommend a multidisciplinary approach to helping this child. First, I would encourage a close relationship with his diabetes team, to insure that this boy’s blood sugars are in reasonable control and that there are not huge fluctuations in his blood sugars during the school day. Second, I would encourage a complete psychoeducational evaluation to assess his abilities, achievement, attention, memory, planning and organization skills. Based on the findings of the above two suggestions, I would encourage the school personnel, the diabetes team, and the parents to work together to develop a plan for helping this young man show responsibility for the appropriate academic and behavioral demands of his educational program.

JWB