From Dallas, Georgia, USA:
My son was diagnosed with type 1 diabetes in July 2009. His latest A1c was 7.9. For the most part, we have been able to keep his blood sugar in control, though rarely in range lately. He has been going through a tremendous growth spurt and it seems like since that started, his morning numbers have been very hard to control. He has a pattern of going from mid-200s mg/dl [13.9 mmol/L] or higher to 30 to 50 mg/dl [1.7 to 2.8 mmol/L] in just one hour, mid morning or shortly before lunch. His diabetes team has made many recent changes, but the best day was still 270 mg/dl [15.0 mmol/L] to 44 mg/dl [2.4 mmol/L]. He is having troubles at preschool during this high to low sugar timeframe. They are behavior problems that start out as arms crossed with stern look on face to hitting, stomping, throwing toys...basically a tantrum. At home, I can catch this behavior before it turns into much. I sit him down and we can talk through the emotions before they spiral, and we keep an eye on his blood sugar and keep it from dropping so low. At school, the initial "set off" gets overlooked; his emotions become uncontrollable and everything seems to spiral and it becomes a full blown tantrum that disrupts the classroom. The teachers are concerned about the behavior problems, but I am having a hard time separating the behavior from the crazy blood sugar numbers. I see it more as out of balance emotions during the blood sugar spike and sudden drop. We do not have tantrums at home and he does not exhibit these behaviors in the afternoon, at school or at home. Could it be from the blood sugar?
Yes, it is very likely a result of the blood sugars, particularly when he begins to go low and then when is below 80 mg/dl [4.5 mmol/L]. Please work closely with your diabetes team to prevent these lows. If the behaviors continue, then I'd consult with a specialist in child behavior.
Additional comments from Dr. David Schwartz:
I suppose the change in behavior could be related to rapidly falling glucose values. Do you have glucose readings at the time you can detect the subtle changes at home and/or glucose values during peak tantrum? Do the behaviors resolve within 10 to 15 minutes of some fast-acting sugar?
I might be able to comment more if there were more information such as specific insulin doses, meal plans, activity calendar, etc. A continuous glucose monitor for several days might be helpful. Your diabetes team should be able to advise you about this.
Last Updated: Tuesday January 11, 2011 10:12:35
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