My daughter was diagnosed with Type 1 diabetes a little over a year ago. She was 3 years old at the time. As a registered nurse, I am familiar with the disease and its complications. My question deals with the co-morbidity of other autoimmune disorders. She has very frequent abdominal pain regardless of glucose levels. She has been worked up for both celiac disease and renal Insufficiency, both of which were negative. Are there other conditions that may cause the abdominal pain that relate to diabetes? Her IGG levels were elevated at 146, but the more reliable test the IGE was negative. Should we continue to have her re-tested every six month as follow up?

You didn’t mention if she was also tested for an underactive thyroid (hypothyroidism), which is common in children with diabetes. Constipation is frequent in untreated hypothyroidism. Young children may report abdominal pain which is caused by constipation, but may be unaware that they have constipation.

Many children without diabetes have abdominal pain. She could be lactose intolerant, have abdominal migraines, urine infection, school phobia, inflammatory bowel disease, or otherwise be healthy with non-specific pains. I find that after diagnosis of diabetes, many children complain of headaches and abdominal pain which doesn’t seem to have a specific cause. If she is otherwise growing normally and her pains don’t interfere with daily activities, and medical evaluation is negative, I would be sympathetic of her discomfort, but reassuring that there is probably nothing “wrong” with her to worry about. If there is no medical cause found, and reassurance doesn’t help, a psychological evaluation might be helpful. Newly diagnosed diabetes is stressful for the child and the family and may also make it more difficult for the child or family to deal with other life stresses that preceded the diagnosis. Ideally, all newly diagnosed children and their families should initially speak with psychological counselors. Unfortunately, this is often not so easily done.

TGL