Welcome to HCM! 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 an 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 donot 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 behaviour, 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 you Feel free to ask more questions Dr. Manisha Gopal