Diabetes and Domestic Violence

Diabetes is an ugly disease, affecting the physical health of those who have it.  It may also affect the mental health of victims.  Anecdotal evidence suggests that it may be the cause of some verbal and physical violence in the home.

What we know.

• 29.1 million Americans have diabetes, according to a 2014 study by the Centers for Disease Control.
• Of these, 8.1 million are undiagnosed.
• Another 86 million are pre-diabetic, meaning they are at risk for development of the disease.
• Diabetes results from a hormone imbalance (insulin) that results in excessive glucose (sugar) in the bloodstream.
• Diabetes places a person at risk for heart disease, kidney disease, blindness, risk of amputation, and death.  It was the seventh leading cause of death in 2010 in the US.
• Diabetes may develop at birth or occur in adults.  Risk factors include poor diet and obesity. (1)

What we’re not sure about and need to know

Excess sugar in the blood is anecdotally associated with mood swings and “irrational” behavior.  Most researchers have focused on eating disorders and the willingness of those suffering from diabetes to make the necessary behavior changes to control the disease.  However, that may not be the whole story.

• The American Diabetes Association apparently considers “diabetic rage” to be a reaction to the diagnosis.

Diabetes is the perfect breeding ground for anger. Anger can start at diagnosis with the question, “Why me?” You may dwell on how unfair diabetes is: “I’m so angry at this disease! I don’t want to treat it. I don’t want to control it. I hate it!” (2)

• However, there is both research on children and anecdotal evidence among adults that mood swings and rage behavior  occur independent of diagnosis.
  • A mother talks about a child with Type 1 Diabetes and how poor behavior is linked to low or excessive blood sugar levels. (4)
  • Joslin researchers reported a link between high levels of glutamate (a neurotransmitter produced by glucose) to symptoms of depression in people with type 1 diabetes. (5)
  • “Behaviors such as aggression, delinquency, and hyperactivity In children with type 1 diabetes, are associated with high blood glucose (sugar) levels.” (6)
  • There is a blog thread on people who have direct experience with violent behavior associated with abnormal glucose levels. (7)

Gonder-Frederick and colleagues comment on the lack of research on the social and behavior impact of hypoglycenia (abnormal blood glucose levels).(8)  Balhara points to the existence of a relationship between diabetes and psychiatric disorders, and also to the lack of research focused on this link.(9)

Mary de Groot and her colleagues focus on the relationship between diabetes and depression, anxiety disorders and more severe forms of mental illness (e.g., bipolar disorder).(10)

In my own family, my grandmother was apparently prone to verbally abusive outbursts as a young woman.  These outbursts apparently stopped when she was diagnosed as diabetic and placed on an insulin regimen.

My wife’s first husband was verbally and physically abusive.  He was also diagnosed late in life (after their divorce) as diabetic, and was about to remarry when he died.  Could earlier diagnosis have put a stop to the abuse?  There’s just no way to know.  Hindsight only goes so far.

What you need to consider:

• If you know someone who is abusive to family or  coworkers, does the person have characteristics that might suggest they are diabetic?  For example, are they overweight?  Does their demeanor change before and after meals? 
• Have they been tested for diabetes?  Are they willing to be tested?

Caveat:  I am a researcher, not a doctor.  If you think there is an issue in your family, you need to consult with a medical professional and determine whether diabetes might be a factor in what you are seeing.  If it is, it needs to be managed.  It’s not something you can ignore and hope it goes away.

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Sources:

1. Centers for Disease Control and Prevention, “National Diabetes Report 2014.” http://www.cdc.gov/diabetes
2. American Diabetes Association, “Anger”, http://www.diabetes.org/living-with-diabetes/complications/mental-health/anger.html
3. Liberty Medical, “How does elevated blood sugar affect a person’s behavior and mood?” https://libertymedical.com/diabetes/question/how-does-elevated-blood-sugar-affect-behavior-and-mood/
4. Insulin Nation, “Bad Behavior or Blood Sugar Swings?”  http://insulinnation.com/living/bad-behavior-or-blood-sugar-swings/
5. Joslin Diabetes Center, “Emotions & Blood-Sugar Levels: How Diabetes Can Affect Your Mood,” 8 July 2014.  http://blog.joslin.org/2014/07/emotions-blood-sugar-levels-how-diabetes-can-affect-your-mood-2/
6. “Sugar Levels Affects Behavior of Children With Diabetes,” 9 October 2007. http://www.diabetesincontrol.com/sugar-levels-affects-behavior-of-children-with-diabetes/
7. “High Blood sugar and irrational behavior,” Blog discussion, 24 March 2006. http://www.ourhealth.com/conditions/diabetes/high-blood-sugar-and-irrational-behavior
8. Gonder-Frederick LA, Clarke WL, Cox DJ. “The Emotional, Social, and Behavioral Implications of Insulin-Induced Hypoglycemia,” Semin Clin Neuropsychiatry. 1997 Jan;2(1):57-65.
9. Yatan Pal Singh Balhara, “Diabetes and psychiatric disorders,” Indian J Endocrinol Metab. 2011 Oct-Dec; 15(4): 274–283.
10. Mary de Groot, Sherita Hill Golden, Julie Wagner, “Psychological Conditions in Adults With Diabetes,” American Psychologist, 2016, Vol. 71, No. 7, 552–562.