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From Virginia:

I am a teaching parent who has taken in a 10 year old boy who was diagnosed with type 1 diabetes two years ago, and I have been told one of his behaviors is manipulating his blood sugar levels for attention. I keep all medications locked up, I watch him check his blood sugars, and I measure out his insulin and watch him do his injections properly. I did recently learn that if he doesn't wash his hands properly before each blood sugar check it will show HI if he has anything on his fingers such as ketchup, syrup, etc. Can certain soaps do this? He was caught putting tree bark in his mouth chewing it and spiting it out sure enough he was higher than usual that evening. Besides using actual food to increase or decrease blood sugar, how else can he be doing this? What more can I watch for?


In my experience, many kids have done something to manipulate their blood sugar levels. I think that it is a normal thing to do when a boy (or a girl) has diabetes and doesn't feel comfortable with it, but I also think very few people can say they are comfortable with Mr. Diabetes. You have to let him free to express himself, without looking at him too strictly.

If he sometimes wants to be in the center of attention, it is also a normal thing, and I am convicted that in a few time he can have a normal behaviour again. The ways people use for manipulating their blood sugar levels are many. One time a 15 year old patient of mine wrote down for me all the ways he could manipulate his blood sugar for me, and I assure you that these ways are so many you can't imagine and the fantasy of the kids is never ending.


Additional comments from Joyce Mosiman:

Sometimes children find creative ways to inject insulin which is not really injecting -- pulling the needle out enough to allow the insulin to drip out or shooting it without placing it in the skin. I think it might be helpful if you actually injected the insulin. This is commonly recommended when blood sugars are constantly out of control in spite of everything looking like it is being done appropriately.


Additional comments from Dr. Donough O'Brien:

Other members of this team have detailed the ways that children may try to falsify blood sugars and how this can be circumvented. I only wanted to add that I would think it important that this boy get seen by a medical social worker, and if need be by a clinical psychologist to try to uncover the reasons for his behaviour.


Original posting 11 Nov 2003
Posted to Behavior


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