Blood glucose levels and problem behavior.

Eberhart et al. (2006) watched one adult with developmental delay. They took blood sugar readings and counted problem behaviors across the day.

No treatment was given. The team just tracked how often the person hit, kicked, or yelled while glucose went up and down.

When blood sugar climbed, problem behavior climbed too. High readings acted like a setting event that made aggression more likely.

The link showed up fast. A spike at breakfast often came with a burst of hitting before lunch.

Neuringer et al. (2007) saw the same pattern with pain and illness. On sick days, behavior worsened just like it did on high-glucose days. Both studies flag hidden medical events as setting events.

Matson et al. (2013) looked at 58% of adults with ID who have poor glucose control. Their data widen the warning: many clients may walk around with high sugar and unknown risk for behavior spikes.

MacRae et al. (2015) reviewed diabetes in ID and found care is often missing. Together the papers say: check glucose first, then treat behavior.

You can add a quick glucose check to your ABC data. If the number is high, delay new teaching and give water or meds first. This simple step can cut escalation and protect dignity without extra restraint.