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July 5, 2001


Question from Harlow, England:

My 22 year old son has had type 1 diabetes since age nine, has suffered from severe thrush and been circumcised to relieve it, has had sinusitis and had his sinuses cleared and widened, was diagnosed with celiac disease about nine months ago, and I believe was lactose intolerant as the pains didn't stop until he started a dairy free diet. He is now able to tolerate milk which I know is probably due to the improved lining of the intestine. Six weeks ago, he developed a severe rash on his feet accompanied by severe pain. The rash disappeared, but the pain didn't. He also lost his appetite completely, became chronically tired. and developed ketones as a result of not eating. As a result, he was tested for Addison's disease, but since we have not heard from the specialist, we feel it can't be that. Now, he has regained his appetite to a degree and got ridden of the ketones by injecting more frequently, but he still has severe pain. Could the severe pain be diabetic neuropathy? Could the celiac condition be upsetting his blood sugar levels to a degree that would cause neuropathy? Is the rash (like a red heat rash on his feet) a symptom of diabetic neuropathy?


It sounds like your son has had more than his share of problems to deal with. A rash is not part of diabetic neuropathy, but he has had diabetes long enough to have it. It is generally thought that neuropathy is more common with a longer duration of diabetes and in individuals with poor control. One form of neuropathy is a painful form with knife-like or “pins and needles” pain. A rash is not necessarily part of this. However, there is a condition known as shingles, from a latent chicken pox infection, which can cause skin lesions and persistent severe pain. He would need to see the physician to have this diagnosed.