My teenage children have Type 1 and are having more hypos as they become more independent. Symptoms can come on fast and make them angry, but getting them to have juice or jelly beans is a stand up fight. How do I handle this now they’re older?

Hypos can cause bad temper and stubborn behavior, even in an otherwise easy-going person. Trying to confront them while they are in the hypo zone can lead to arguments, so I have a couple of suggestions to avoid this. Without saying a word, get their blood glucose meter and set it up so they can test themselves. If they can’t manage this, you can carry out the test. When the numbers display a low level, its hard for them to argue they’re not having a hypo state.

I sometimes find when they are really low, they just aren’t capable of assembling their kit, doing a test, or getting the food they need to bring their levels back to normal. Their brain is starved of glucose when they are hypo so they aren’t thinking straight. This is why they have little control over their mood and get angry. Once they have had some carbs and recovered, they are usually very remorseful about their behavior.

I would also encourage them to discuss their unstable BGLs and hypo unawareness with an expert, their specialist, or diabetes educator.As they progress into adulthood and take on responsibility for their own diabetes management, it’s really important that they develop a good relationship with their health team. It could be that their frequent low blood glucose episodes are a result of hypo unawareness which makes it hard to take preventative action before the hypo hits. Your child’s health team can help them with this – an action plan can usually reverse the problem in a couple of months.

If your children are on injections, they may suggest considering an insulin pump. Since my kids started using pumps, I’ve found swings in their BGLs are slower and much reduced. Using a continuous glucose monitor, which measures levels 24 hours a day, alongside the pump is an extra precaution. Not only is the BGL displayed on the pump screen, they can prime an alarm to alert them if their levels exceed or fall below preset measures or are dropping too rapidly.