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From Shirley, New York, USA:

My seven-year-old son was diagnosed with type 1 diabetes when he was three. He is currently in second grade and is very bright intellectually. The problem is with his behavior. When he goes low, he gets very angry, defiant, pushes, hits until he gets treatment. Then, he may not even remember doing those things or saying things. He has had a few lows at school (24 mg/dl [1.3 mmol/L] to 66 mg/dl [3.7 mmol/L]) and has gotten into trouble because he pushed someone or gave them a raspberry. Sometimes he is totally unfocused and unresponsive at school and the teacher says that he is just "not there." Is this common?

The teacher says he was unresponsive yesterday, but his number at lunch was 136 mg/dl [7.6 mmol/L]. She said he was out of it all day. Do you think this is diabetic related or should I be searching out other avenues? Most of the time he is happy and eager to please, but some days he is totally unfocused, seems lost and is extremely emotional and it seems to be getting more commonplace.


It is certainly attractive and understandable to ascribe "all" physical and emotional health issues to a child's diabetes. Certainly, what you describe could absolutely be due to low glucoses, except during the time that you checked and his glucose was 136 mg/dl [7.6 mmol/L].

First of all, remember that the glucose meters are not infallible. They have to be calibrated or checked. Remember the bottle of control solution you first got? Well, THAT bottle is no good anymore. Do you have to match the code on your strips to the meter? Some meters require this, while others don't.

If he acts low and his glucose is low, then I'd treat the low. If he acts fine and his glucose is low, I'd recheck the glucose to see if there was a "false positive." If he acts low and his glucose is fine, I might also recheck the glucose to be sure this is not a "false negative."

All that said, it probably is hypoglycemia. A continuous glucose sensor might help to see when his glucoses tend to drop when you're not checking. It can also help demonstrate the rate of the drop in glucose.

What else could this be? Tiny absence seizures? Attention Deficit Disorder (ADD)? Perhaps.

Talk with your diabetes team about ways, such as a glucose sensor, to better delineate his glucose patterns during his "behaviors," but the input from a child psychologist well trained in behavior issues and ADD might be in the future.


Original posting 29 Jan 2008
Posted to Behavior and Hypoglycemia


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