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From West Texas, USA:

I live with my soon to be and dearly beloved wife, who has three children The youngest, age 10, has type 1 diabetes treated with an insulin pump. While I struggle to place some sense on the roller coaster behavior of a 10 year old girl, I also deal with two others and their individual problems. The problem arises that the youngest is, in my opinion, given far greater latitude in behavior problems, while the others are repeatedly chastised by mom for any such bad behavior. (Example: I specifically told her to pick up her room and specifically pointed out what needed to be picked up, only to find that several hours later the task was yet to be done. Mother's excuse is that the sugar was too high and that she simply forgets and becomes disoriented.)

It appears to me at least and to the other children, that too often the poor behavior and disregard is blamed upon the diabetes, rather than upon the behavior problem. My first opinion is that the child knows more than I do, especially about proper regulation and eating habits, therefore it is her first responsibility to properly monitor these things and be honest with herself. Is this a true assumption? Often I have caught her slipping some food, like finger dipping, into a piece of pie or having a few potato chips, without accounting for them. Mother seemingly cannot see the necessity in making her become more responsible and fails to discipline her in the same manner that she would the other children, citing to me that such upsets will only increase her sugar level. Is that true?

I also have a terrible problem with the boy, who seems to be carrying a big load of "give her a break because", when he is fifteen and she is ten and that just does not match up no matter what we all want to have. Even normal households, big brother is not in the habit of cutting slack to little sister or allowing her to hang out or swap smart remarks with him or his friends. By the way, the oldest child, age 18, has and continues to refuse to be involved in helping or even addressing the problem and basically acts like a sister in absentee most of the time.

I feel very badly because I can see that she does require special medical attention, but I don't think it requires always making an excuse for misbehavior, snappy remarks or just not paying any attention. If I am wrong in attempting to treat her as one of the other children and truly these are effects of diabetes, then tell me that I am wrong. If I am not, then explain this to her mother for me because it is about to drive me insane.


You raise many important issues that should be addressed as soon as possible, both for the well-being of this 10 year old girl, but also for her sibling's happiness and the success of your upcoming marriage.

In general, the only time a child should be given "a break" because of their diabetes is when they have a low blood sugar (typically 70 mg/dl [3.9 mmol/L] or below). Once the blood sugars are low, the brain does not have enough energy to function completely, and misbehavior and poor concentration as well as other symptoms may occur. Any numbers over 70 mg/dl [3.9 mmol/L], even if they're in the 200s and 300s mg/dl [11.1 and 16.7 mmol/L] should not be used as an excuse for misbehavior (if you're running high numbers you may not be feeling very well, but that is not an excuse for not doing what's expected).

I would strongly encourage you and your fiance to meet with a psychologist or other mental health professional with expertise in children with diabetes. Even if you meet a few times to review strategies for co-parenting the children (with and without diabetes), and review the specific issues related to diabetes and a child's behavior, you will have spent your time well. Please contact this child's diabetes team for referrals.


Original posting 25 May 2003
Posted to Behavior


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