Ain’t Misbehaving: Is it Fair to Punish a Hypoglycemic Child?

No child is born knowing how to behave. Kids need parental guidance. Children with diabetes are no exception. After four years as the parent of a child with type 1 diabetes, I’ve learned that even (or especially) while experiencing hypoglycemia my son needs guidance, although perhaps not as much as he needs juice. Meanwhile, hypoglycemia can cause uncharacteristic behavior in otherwise angelic kids. After the juice box has been drained, how can a parent address what may have happened while the child was under hypoglycemia’s spell?

My younger son was diagnosed with diabetes when he was eight years old. Although he was not a baby, not a toddler, but a full-fledged schoolboy, it was easy to give a free pass to strange hypoglycemic behavior. He’d do some bewildering thing and then a few minutes later we’d realize oh riiiight, he’s low! Hypo highlights from that era include: the time he punched the basket on my bicycle, the time he was suddenly desperate to remove his socks and did so, in a restaurant, and the time he called me, from school, because he couldn’t recall and urgently needed to know the name of a friend’s guinea pig.

During our four years with diabetes, however, the unusual hypo behaviors have morphed. Most hypos come and go without incident, but low blood sugar quirks still pop up. Examples: reclining in the booth of a restaurant between bites of lunch, reading a book instead of listening to a teacher, walking down the middle of the street in order to follow a wiggly, drizzled line of tar; and, most recently, wandering away from our family and friends into the unfamiliar woods of New Hampshire.

After locating the wanderer at the base of the mountain, I attempted discipline. I found him reclining Candy-O style on the hood of our car. Hi. You know you can’t do this. You can’t just wander off. We were worried about you. He looked at me blankly. I told him this was an egregious error, gravely serious, and that as a consequence I’d have to (brace yourselves for the ferocity) take away his phone. He said he didn’t care. This began what seemed to be a sequel to Maurice Sendak’s Pierre. (I was so worried. I don’t care. Our friends were so worried. I don’t care. We’ll have to walk back up the mountain to apologize. I don’t care.) Nothing I said moved him. A triple-buzz from the CGM receiver in my pocket spared me from saying more dumb things. Back within range of its transmitter, the device announced a hypo. Maybe Pierre had hypoglycemia too.

After a few glucose tabs took effect, our Pierre was eager to make things right. I can’t believe I just walked away from you guys. It was like I was delusional! I’m really embarrassed. This change of heart was a relief, but also problematic. Fast-acting carbs had worked their magic. Abracadabra! Ladies and gentlemen, the kid who deserved to be punished for being an inconsiderate jerk had vanished, and voilà: in his place, a contrite sweetheart.

Regardless, I took the sweetheart’s phone away. It didn’t seem right to brush this experience off with hypoglycemia as an excuse. We attempted to plan for the future: What can we do differently if you feel like wandering off again some day? He suggested, “I guess I’ll just sit down somewhere you can see me?” That seems like a reasonable solution, however, the guy who shows up when blood sugar plummets isn’t always reasonable. How can I get that guy to stick to our plan, or any plan? Can parents do anything to cultivate the skill set for remaining cool, calm, and collected in hypoglycemic diabetic kids?

My best hope—and I am really counting on this one—is that these skills develop organically from experience, though I know that even adults who’ve had diabetes for decades sometimes act strangely when low. My expectation is that my son will learn to maintain a façade of normalcy while low, and that developing such a talent is less like learning to Whip and Nae Nae and more like learning to walk. Some parents might be impatient for their babies to walk, but child development experts tell us there is not much we can do but wait. Let it happen. Encourage. Know they will stumble. Put socks with rubber-patterned bottoms on their feet and foam bumpers on sharp table corners. Be optimistic. They’ll figure it out eventually. Someday, not today, they will run.

[youtube]https://www.youtube.com/watch?v=vjW8wmF5VWc[/youtube]

Katy Killilea

Katy Killilea lives in Rhode Island with her family. The younger of her sons was diagnosed with Type 1 diabetes in 2011 when he was 8 years old. Two years later she was diagnosed with Type 1 herself. Her older son is a test subject in an experimental trial for a drug that stops the progression of Type 1 diabetes. This son, her husband, and their dog remain (relatively) unaffected by diabetes. She writes the blog Bigfoot Child Have Diabetes.