My daughter is nine years old and was diagnosed with Type 1 diabetes at the age of 5. Upon diabetes diagnosis, I also advised the medical staff of other problems, i.e., constipation, short stature, etc. In the hospital, she was then diagnosed with hypothyroidism and has been taking Synthroid. These past nine months, she has had HbA1c of 9.9 and 10.2 and been constantly complaining of stomach pain. We do 4 daily blood tests and 4 shots (Regular/NPH/Humalog). Her body still is not responding to the insulin with excessively high sugars. Could there be something else wrong with her pancreas, i.e., pancreatic cancer? She is sen every 3 months by an endocrinologist was re-evaluated at a Medical School.

There are many causes of abdominal pain in a nine year old girl and in someone who is not diabetic it would be important to consider a urinary tract infection and also the possibility of anxiety over psychosocial issues. In her case however, it is possible that she has a condition sometimes known as the ‘Autoimmune Polyglandular Syndrome Type II’ in which a group of autoimmune conditions occur together. Diabetes and hypothyroidism are the commonest; but up to 10% of new onset diabetics in childhood may have anti transglutaminase or anti glutamyl transferase antibodies in their serum which is indicative of celiac disease, yet another autoimmune condition. Such a diagnosis could account for the not very good control and for her abdominal pain. It would certainly be appropriate to talk to her doctor about getting the antibody test done. She might then need to have the diagnosis confirmed by a small bowel biopsy and then if that was positive to start treatment with a gluten(wheat) free diet. The latter step is not easy, but it is effective and there are good books to help with management.

DOB
Additional comments from Dr. Tessa Lebinger:

I would also consider lactose intolerance (intolerance to the sugar in milk) which is quite common, can cause frequent abdominal pain, and is unrelated to diabetes.

TGL