Your child is in the midst of a temper tantrum, which a kid will do no matter what his age, and before you discipline him, you stop yourself with these questions: "Maybe it's his blood sugar. Maybe he's low again. Maybe his BG readings are high. Then again, maybe he's just plain acting out."

These questions plague most parents with children who have diabetes: How can you really know if a tantrum is just bad behavior or if it's diabetes?

Diabetes adds in a new level of complexity to parenting and specifically to reading and then managing a child's behavior. Before a diabetes diagnosis, an all-out temper tantrum may have meant a trip to the Time-Out Corner. Or, if you've an older child, a fast trip to his room with all privileges revoked (and don't forget to give me your phone and iPod on your way to room!)

Now, with diabetes in the picture, parents need to consider whether or not BG levels are impacting their kids' behavior.

Low blood sugar, or hypoglycemia, is characterized by symptoms like mood changes, irritability, irrational behavior and even belligerence. Parents of Type 1 kids know these tell-tale signs all too well and often pull out the glucose tabs as their first line of defense.

On the other hand, high BG levels or hyperglycemia can impact behavior too. Symptoms are wide ranging, and include general malaise, difficulty concentrating, nausea and headaches. My son likens prolonged high blood sugars to being poisoned. Who's not going be a bit on the cantankerous side if he's feeling like that? The ADA conducted a study with feedback from 42 parents with Type 1 kids aged 5 to 10. For the study, researchers measured a child's BG levels twice during a 72-hour period and had his parents fill out a questionnaire with behavior-related questions during the corresponding period in time. The results, although qualitative, found that kids tended to act out more when BG levels were high as compared to normal levels.

Bottom line: your child's behavior certainly might be affected by BG levels, and significantly.

Put An Action Plan In Place

So what do you do? What can you as a parent, with so many moving parts to keep track of, do? I recently sat in on a presentation by Ann Bartlett to parents at a Type 1 Friends meeting, a support group based in Northern Virginia. Ann, a fellow HealthCentral blogger and Type 1 for over 40 years, recommends that the child and parents have an action plan to turn to so that the child can go on autopilot when blood sugars are out of whack.

For the child, this plan can be as straightforward as sensing that something is not quite right, then testing his blood to see if he is high or low (and symptoms can be easy to mix up, one can feel like his blood's plummeting, but it is actually high). Once the BG is tested, then treat accordingly. If low, take glucose tabs or something else to bring up blood sugars and furthermore understand that this need is more immediate and the symptoms are short-lived.