My thirteen year old daughter was diagnosed with type 1 diabetes two days prior to her seventh birthday and has been on an insulin pump for almost four years. For eighteen months, she has suffered with what the neurologist calls vascular/migraine headaches of a chronic nature. We have tried Elavil, Advil, Excedrin, Topomax, homeopathy, chiropractic, and cranial-sacral treatments, but nothing offers relief from the pain, and her entire life is impacted. Biofeedback has been suggested, but I just can’t be comfortable with the idea that “the headache is not going to go away” as the neurologist says.

Many people ask me, “Do you think this is related to diabetes?” Her A1cs are 6.7-7.2%, she has had her eyes checked, and has braces on teeth. I feel like I have looked everywhere, and am on the edge of crazy, and I think: Can these be related to diabetes? I know it can be related to hormone activity, and she is struggling through puberty. Do you know of similar cases? I just can’t believe there is no relief for my daughter.

It’s extremely unlikely this is related to diabetes at all with such hemoglobin A1c levels and the treatment you describe. If there is a family history of similar migraine or vascular headaches, more likely this is the culprit. If others in the family have had success with one medication or type of treatment, this may also provide a clue as to what may be tried with your daughter since treatment responsiveness may also be familial. MRI, CAT scan, and sometimes EEG are helpful as part of evaluation, particularly if these are chronic and resistant to usual treatments. Hypoglycemia may exacerbate or touch them off as may hyperglycemia, but usually there is no relationship at all to blood glucoses in my experience.

Some of the anti-migraine medications that are new the past few years may be worth trying in consultation with your daughter’s neurologist. Acupuncture as well as many kinds of relaxation techniques (biofeedback, Oriental pressure points, yoga) all have good success, but the key will be to try to find local experts who can help teach this to your daughter and then support her practicing when she does not have the headaches — so she can use these same technique when the headaches surface. Such headaches often get better after several years of pubertal hormone changes.

SB