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March 31, 2002


Question from Wellman, Texas, USA:

We have been recently told by a psychologist that my nine year old son, who has type 1 diabetes, could also have ADD. The doctor said this could possibly be related to his diabetes, but that he is not a physician, and doesn't know very much about hyperglycemia and how it might affect my son's ability to focus his attention on a task. My son is not a behavior problem and has never had trouble paying attention at school before his diabetes diagnosis. His last A1c was 9.2%, and his endocrinologist said this was as tight control as to be expected of a child his age. Can his high blood sugar make it difficult for him to concentrate? Also, could this be mimicking signs of ADD? I thought that ADD was something you were born with, and this a relevantly new problem!


I don’t know the details of your son’s care and thus am not privy to the perspective of your endocrinologist. A hemoglobin A1c of 9.2% is fair control, but I’d prefer my patients under 8% if possible, recognizing that “tighter” control leads to increased chances for symptomatic hypoglycemia.

High glucose readings may indeed affect concentration, but is that ADD? I don’t think so. One of the more common symptoms of ADD (one does not have to be “hyper” to have ADD) is a degree of impulsivity and some degree of inability to stay on task. Also, ADD is not a diagnosis that one can reliably make after one or two office visits. Generally, there are also special forms and questionnaires for family and teachers to fill out in order to score it and get a profile of the child’s behavior. If you are working with a counselor who does not primarily work with children, and who is unfamiliar with hyperglycemic effects on attention and behavior, I’d have you think about considering a second opinion.