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Question:

From Tacoma, Washington, USA:

As a school psychologist and part of a student evaluation team, we are working with a 16 year old female with Type 1 diabetes, diagnosed at about age 9. She has high and sometimes very poorly controlled sugar levels and is erratic about taking the insulin. She shows behaviors in the last year that are "bipolar-like," for example, out of control rages, distorted reality, placing herself in dangerous situations, depression, suicide attempts. There is no family history of bipolar. Could high blood sugar levels over a long period of time produce the bipolar effects? I can't find anyone who seems to know about this, but some say that have "heard" of some relationship. Is there any medical reason why lithium or one of the mood stabilizers or anti-seizure drugs shouldn't be tried? She has excellent doctors and support people to work with, but they are at a loss and are seeing this girl as just being manipulative. We are not so sure. Could we be dealing with a parallel and/or interacting biochemical problem? How would you suggest we proceed?

Answer:

This question was referred to several members of the Diabetes Team, who have each given an answer:

Answer from Dr. Robertson:

This type of problem is best dealt with in a multidisciplinary way. The Diabetes Team and psychology/psychiatry teams need to discuss the interaction of manipulative behaviour and genuine hypoglycaemic symptoms (if she has any). Any attempt to deal with such a girl on an individual basis will almost certainly result in her playing one off against the other.

I know of no specific link between bipolar psychiatric disorder and diabetes.

KJR

Answer from Craig McAlister Broadhurst, Clinical Specialist in Counseling:

In my nine years of counseling with persons having diabetes, I have not encountered a patient who had a connection between bipolar disorder and diabetes per se. This situation simply cannot be quid pro quo. It does sound serious and I would run, not walk, to a qualified child psychiatrist for in-depth assistance.

In addition, I personally find that people assess others struggling with suicidal ideation as "manipulative" when they feel out of their own comfort zone!

CMB

Original posting 8 May 1998
Posted to
Behavior

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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