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February 8, 2001

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Question from Wilton, Connecticut, USA:

I am the mother of a six year old, diagnosed at age two, and I have relied on the Diabetes Team since my son's diagnosis as a valuable resource. However, I am continually frustrated by the Team's response to questions regarding stomachaches as being psychological in origin once other physical causes such as celiac disease or lactose issues have been eliminated. My son complained constantly of stomachaches until he went on the insulin pump. In fact, three days after starting pump therapy, he proclaimed, "My tummy doesn't hurt anymore"! I firmly believe that constant glucose fluctuations, can cause upset stomachs. Wearing the glucose sensor prior to and after the pump clearly demonstrated the stability the pump offers. While his Hemoglobin A1cs remained the same, 5.7-6.1%, and we now rarely have readings over 250 mg/dl [13.9 mmol/L] or under 50 mg/dl [2.8 mmol/L]. Prior to pump therapy, 400s mg/dl [22.2 mmol/L] were not unusual, nor were readings 30s [mg/dl, 1.7 mmol/L], despite MDI [multiple daily injections] and much support from our diabetes team. While glucose fluctuations do not explain all stomachaches, and yes, I believe some are psychological, I wish the possibility of glucose fluctuations would be offered to your readers as one of the possible explanations.

Answer:

I appreciate your comments. In my experience, both kids and adults describe “odd feelings” at times, including stomachaches such as your child. Sometimes, these can be correlated with rapidly rising or falling blood sugars through blood glucose monitoring and sometimes not. Regardless of the exact blood sugars at the time, I believe such feelings are a factor for some people. The sudden relief you describe reminds me of several people who made similar comments when they switched from lifelong use of Regular to Humalog for meal coverage. Whether their perceptions were related to more stable control or to simple eliminating higher than physiologic levels of insulin between meals, we have no way of knowing, but several talked about “feeling normal for the first time since I’ve had diabetes,” and “lost that gnawing feeling in my stomach.” These are perceptions, not science, but reflect people’s true experience of their diabetes and should be attended to by health providers.

BB