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Thread: New Diagnosis - 12 year old - Diabetes 1 + Bipolar

  1. #1

    Unhappy New Diagnosis - 12 year old - Diabetes 1 + Bipolar

    Hi, all. It's been slightly over a week since my 12-year-old son's diagnosis.

    Diagnosis:
    The week before last he had been sick - vomiting, tired, and very thirsty and frequently urinating (though I didn't think of this as a symptom at the time because it seems like he's always been like that) and by Saturday, he was unable to keep anything down, had rapid breathing, and had pain in his stomach. In the last month or so, he'd also lost a noticeable amount of weight.

    We took him to the emergency room. They checked his blood, urine, ran a ultrasound on his stomach/pancreas/liver/etc. and an x-ray. They gave him some morphine for the pain.

    Some time after, the ER doc said he was Type 1 Diabetic, experiencing ketoacidosis, with glucose level at 498. He was given insulin and a saline IV, and kept until Tuesday, by which time they had decided that we could handle giving him the shots, testing his glucose, and changing his diet. He's currently prescribed 75g of carbs per meal plus three 15g snacks, with sliding scale insulin at meals (Humalog) and 35 units of insulin (Lantis) at night. We also have to check him at 2am (for how long I have no idea).

    We are still waiting on test results for tests they did at the tail end of his stay for celiac, thyroid issues, and diabetes markers.

    Background:

    Since preschool, he was diagnosed with ADHD. More recently (in the last 6 months), he has also been diagnosed with bipolar disorder, PDD/high-functioning autism, and generalized anxiety disorder. If you read the symptoms of ADHD or bipolar, he matches them exactly; the other labels not as much, but somewhat. He regularly sees a therapist and psychiatrist, and for the last few months he was on Risperidone/Risperdal for the bipolar disorder (which mostly just made him very sleepy).

    Questions & Concerns:
    From what Dr. Google (the internet) tells me, Risperdal seems to be able to cause high blood sugar / increased glucose levels, cause Diabetes itself, or "turn on" Diabetes. Something to that effect. If that was the case here, can anyone clarify....
    .... Can Risperdal cause Diabetes?
    .... Can Risperdal induce Diabetes in someone who is has an existing predisposition / genetic markers for Diabetes (where they would have gotten it eventually anyway)?
    .... Is there anyway to ever know that for sure?
    .... Is it possible that Risperdal could cause the ketoacidosis only, and the diabetic symptoms are only temporary (fingers crossed)?

    Is it possible that he might have been misdiagnosed as bipolar/ADHD/etc. and that the symptoms were just manifestations of low/high blood sugar?

    How long before the diagnosis could he have had diabetes? I mean, he has always had excessive thirst and urination, and only recently stopped bedwetting (in the last few months)... Could he have had it to some degree since birth, just never manifested into DKA until now?

    Also... he has always had some kind of digestive issues... colicky and projectile vomiting as a baby, reflux-like symptoms since young... could there be any connection there?

    And, since the DKA, he was taken off of Risperdal... the psychiatrist is suggesting Seroquel or Geodon, which both seem to raise blood sugar (and cause weight gain). The endocrinologist is just referring back to the psychiatrist's opinion, and thinks that if it causes higher blood sugar, we can just compensate with additional insulin.
    .... Is it OK to just compensate with additional insulin?
    .... Anyone have experience with Diabetes Type 1 AND Bipolar AND medication?
    .... Any recommended other meds for Bipolar that do not raise blood sugar or cause weight gain?
    .... Any other recommendations for this situation?

    I would appreciate any input you could provide - the docs have just sort of shook their heads on all of these questions or shrugged.

    Sorry if this post is too long or too many questions.

    Thanks!
    Last edited by newtype1; 08-10-2010 at 03:13 PM.

  2. #2
    Join Date
    Feb 2010
    Location
    California
    Posts
    292

    Default

    I am so sorry to hear the diagnosis. My daughter was dx'd in December. Since she was a bout 3 she has struggled with behavior, dx'd ADHD but we chose not to medicate and she saw a therapist and we worked hard as a family (we felt medication was not right for our daughter not that we judge or have an opinion toward those that do). She was VERY coliky as an infant until about 8-9 months (to the extreme), always has had tummy problems. Since dx and we have been "managing" her blood sugar, and by this I mean she does not have regular highs (over 250ish) and lows (below 60ish) but definitely flexuates, she no longer has the tummy problems and I get complimented on her behavior almost daily. She had been struggling socially and now night and day improvement. I am not a doctor I can only speak from our experience and say we are our childs only advocate and we must make it known that we will stand strong beside them. I would consider watching your childs behavior off the meds (if safe for all involved) and see if the diabetes had been the culprit for the behavior problems. Our endo has very strong opinions about the stress the body goes through before dx and that while the beta cells are being attacked and the body is going up and down, so does the way they feel and young kids do not understand and it can definitely cause many other problems. I wish you the best of luck, demand answers from your medical team or make changes to a medical team that will help you.
    Kara- mom to Kerstyn- 10 Dx 12/17/2009 our strength, Sammy- 7 non-D our brains, Krissy- 4 non-D our energy!!

    07/02/10 Pumping pink MM and loving it!!

  3. #3

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    Hello and welcome Im so sorry about your sons diagnosis. He will be feeling lots better though now that he's on insulin. I dont think that any kind of medication can cause type 1 diabetes, I think its quite possible that it could cause high blood sugars or maybe the onset of type 2 but type 1 is an autoimmune disease. You will be able to find out more after the results are in from the antibody test. For now stay in close contact with diabetes team. Call the endo or CDE for advice about diabetes and the other conditions that your son has.

    High blood sugars can cause children to feel very lousy, my son will get very irritable and angry when his blood sugars are high especially if theyve been high for some time. I think the high blood sugars may have been part of your sons problem with behavior but you wont know the full effect until his blood sugars are in range more of the time. Its difficult to keep them in range most of the time so dont feel bad if thats not happening. Chances are your son will start the honeymoon soon and his insulin needs may drop drastically. If he starts having lows get in touch with your endo and let them know so you can make adjustments.

    Come back here anytime with questions or if you need support and understanding from those who know where youre coming from.
    Becky, Mom to Steven 12, dxd 7/04 MDI humolog and Lantus, Harry 14 non-d My 2 awesome boys

    Right now three things remain: Faith, hope and love But the greatest of these is love. 1 Corinthians 13:13


    "There is no rightness in diabetes. Just sometimes, you're less wrong." by Jacobs Dad

  4. #4

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    My son was on Risperdal for a couple of years before his D dx in Jan. this year. It has been linked to type 2 D, I think because it causes weight gain. I haven't looked extensively into whether it can cause or trigger type 1, because there is nothing I can do to change what happened.

    He is currently on Trileptal instead of Risperdal and doing pretty well on it. He also has anxiety, autism spectrum disorder, and they say ODD. I'm thinking the ODD is just a catch-all for his behaviors. Buspar is also helpful - he takes it for his anxiety. It can lower BG so keep an eye on that if your CWD ends up on it.

    I don't think the D is temporary (sorry). Jackson has been on insulin since January with no honeymoon in site (couldn't resist the pun - he's pumping).

    Welcome to the group. Feel free to PM me if I can give you any more help. We have another member here who also has a BP son with D and she can probably help you even more than I can.
    Kim
    Mom to:
    Jackson, age 16 Dx Jan. 2010
    Pinging with insets
    CGM'ing with the G4!

    http://phlings.blogspot.com

  5. #5

    Default

    There are some theories that insulin resistance in a person predisposed to type 1 may accelerate that development. If there's no insulin resistance, that theory is out. The testing for diabetes antibodies and cpeptide should help clarify that, as will his dosage once that evens out.

    As for whether it's okay to just compensate with insulin: yes. That's what the body would do naturally if it could.
    -Jonah
    dx age 17, now 25
    on Lantus for 7 years; on minimed 530 G since 12/7/13

  6. #6
    Join Date
    Jul 2007
    Location
    Maryland (Odenton and Frederick)
    Posts
    1,115

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    Hello and welcome to CWD!

    I am teen with both type 1 diabetes and bipolar disorder. I'm on both Trileptal, Seroquel, and Zoloft. The combination of the two are really hard to treat because anti-psychotics do have a weight gain side effect. Some new meds just came out Sapharis and Invega are similar to risperdal and seroquel but with less weight gain. Since I was dealing with a bit of insulin resistance I did some research and the studies say that metformin can help combat weight gain from APs in children.

    In addition to joining CWD, I would also recommend looking at CABF at bpkids.org.
    Caitlin, 21
    Type 1 Diabetes
    dxd March 28, 2005 at 12 years old
    Minimed 522 (Oct '07 - July '11); Omnipod (July 2011-April 2014); Starting T:Slim on April 2nd, 2014
    Minimed CGM (Jan '12 - March '12); Dexcom G4 (June '13)

    College Student (Dec '14), Majoring in Psychology (orig. Special/Elementary Ed)
    (with the expectation of going to Graduate School for School Psychology right after obtaining my B.A.)

    "Deserve your dream." - Octavio Paz

  7. Default 28yo type 1/bi-polar

    I was doing my own research when I stumbled across your post and I wanted to share my perspective as a 28-year-old man with both Type 1 and Bi-Polar (currently taking risperdal, depakote & lamictal).

    Mental health and Diabetes care are big lifestyle changes. As such, there is a difficult adjustment period, but it gets easier. My psychiatrist tried to avoid meds that would raise my Blood Glucose, but there was still an impact. All of my meds raised it at first, but after a few days I got my insulin doses adjusted and it came down. Keep checking that BG. Hang in there for med adjustments in general. It can be frustrating trying out different meds and doses and dealing with side-effects, but if you hang in there and keep working at it you will find a combination that helps.

    If you are unfamiliar with the Glycemic index: http://www.glycemicindex.com/
    I have found that avoiding high-glycemic foods and artificial sweeteners and instead choosing low-GI carbs with lean meat, low-fat dairy and fresh veggies goes a long way toward keeping my blood sugar (and, in turn, my bi-polar) on a more even keel.

    I also recommend investigating insulin pumps. I prefer the slightly larger needle once every three days rather than 4-6 injections a day plus carrying a whole $100 bottle of insulin everywhere (I'm a bit clumsy). Also, the ability to set Dual and Square-wave boluses has allowed me to eat Pizza again!

    As hard as it is sometimes, I also find strength in my Bi-Polar and Diabetes. The things I had to learn to survive spurred further growth and knowledge beyond my imagination.

    Be well.

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