### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Dear Doctor, my enquiry is regarding my son, he is 31 yrs old and has had juvenile diabetes since he was 23 years old. For a year now he is moody, very short tempered to the stage yelling and screaming at friends and family.Extremely prickly if questioned and gets very angry if plans have been made and then change, even if it is the slightlist change as in street direction or maybe lets go to the eatery next door instead.  Did this come from his relationship break up or is his diabetes developing into something else.  I feel he is depressed and hope it is not bipolar. He is very slim, and exercises a lot, probably not wholly following a good insulin plan.  After being very angry with me he will phone and ask he we want to go out for coffee or lunch the following day,  I see signs of the son I used to have.    Am I overreacting?  My plan if I can get him on the good day is to take him to a Diabetes specialist for a start and maybe some antidepressants for a kick start in the mornings, what do you think? Jacky

### output:

! Jacky I really appreciate your efforts for the treatment for your son, and you are not overreacting at all. From what you have said in question I can say from my clinical experience that your son is having some autistic features (as he strictly follows the same routine and throws tantrums when routine is changed). His mood swings might be related to such events as I can guess otherwise he would talk to you normally. You have not mentioned so, but such people are also strict about their dietary habits and may go to extremes patterns to follow it. The point which is against autism is that he developed this pattern just a year back and not from childhood. Such features are also seen in a condition called OCD. You have said that he looks depressed, which can be seen in OCD (comorbid depression). You have mentioned mood fluctuations in which one side is that -- he gets angry and yells and screams, but the other side is not reflective of manic features, so, I donor think that he is bipolar. However, making a correct diagnosis the psychiatrist must interview the patient herself. One thing is definite that your son needs help and I'm sure that medicines will help him a lot, more than you may even think of. So, I would suggest that you must make a visit to a psychiatrist with him. When medicine will start showing effect his diet will also improve apart from his behavior, this will help in managing diabetes as well. You have asked if these symptoms are related to diabetes or not. Well, I have not gone across any such research work till now where diabetes itself is a cause for such symptoms in any patient. So, it looks unlikely to be so. As you have mentioned that he had a breakup, which can be taken as a stressor, I think it might be related to his current condition to some extent. Hope the reply is useful for feel free to ask more questions