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


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.


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5 years ago

I don’t believe punishing a child while he’s in a low is fair. And I don’t believe you were saying a low is an excuse for bad behavior. I have been struggling with this topic for some time. Analyzing the situation before any punishment is given then discussing with the child how things can be made better is a good way to go. Of course, depending on the child’s age. I don’t believe just letting it go is a fair way to deal either. As parents of child with T1D, it’s fair to say we will all make mistakes every… Read more »

5 years ago

I can’t believe what I’ve just read….

How can you even think that hypoglycemia is an EXCUSE for bad behavior and punishing a child??? Maintain a facade of normalcy? Are you serious????

You need to go back to your endo and educator and get some serious education about diabetes and hypoglycemia. You should know better being TD1 yourself.

Kim – Mom of TD1 son dx’d age 2 (now 22)

5 years ago

Hypoglycemic symptoms and actions are from the individual’s brain not receiving enough fuel (sugar)to function properly. Imagine parts of your brain intermittently turning off or not communicating correctly – that is a reasonable definition of a hypo and explains some of the odd behavior and confusion. I just don’t think punishing a child for having a hypo (assuming they are not doing it on purpose) is a good way to go about things. I think this will lead to hiding/lying about hypos and/or held in bad feelings about parents. These will likely only increase during the teenage years. I mean… Read more »

5 years ago

Thank you for sharing your story. We have a 7.5yo T1d dxd at 6. It helps to hear another point out similar experiences, especially the defiance part, which is hardest for me. But, the eandering off story is eye opening. All the best~

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