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September 26, 2009

Aches and Pains, Honeymoon

Question from Hamilton, Ohio, USA:

My seven-year-old granddaughter, diagnosed in March 2009 with type l, continues to complain of tummy aches. Her diabetes team says it is not caused by diabetes. They did a celiac test several months ago. However, when she was seen by her regular pediatrician previously, he indicated it went along with the diabetes. She's still complaining frequently. Can she still be experiencing tummy pain due to "honeymoon period"?

Answer:

I don’t understand your question in how you relate the diabetes honeymoon phase to the child “still” having tummy pain; the diabetes honeymoon is not typically associated with bellyaches.

I do think your granddaughter’s tummy aches should be explored. Sometimes, depending on how it is done, celiac disease screening can give “false negative” results. Adrenal gland issues, for which type 1 patients are at higher risk, can also cause tummy aches. It is also very possible for even young children to get tummy aches due to increased stomach acid, the same way adults get “stressed” and gastritis/peptic ulcer type symptoms. Your granddaughter may be internalizing the new stresses of diabetes management, especially if her caregivers are rather “hyper.”

The accumulation of body ketones, in sub-optimally controlled type 1 diabetes, are commonly associated with abdominal pain.

Maintain a dialogue with her healthcare providers and seek out consultations as needed, for instance, with a pediatric gastroenterologist, if her regular healthcare team still can’t find an answer.

DS