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July 8, 2003

Daily Care

Question from Los Gatos, California, USA:

Our daughter, diagnosed with diabetes over five years ago, became very unstable after the first year. She was diagnosed with general anxiety disorder and was put on medication to help which worked to stabilize her blood sugars for a while. Then, she had a strange rash that started on her knee then spread to her feet, legs, underarms, and buttocks.She had a biopsy done, but they couldn't determine what it was and blamed it on fluctuations in blood sugar. They ended up putting her on a insulin pump and this again helped for a while. Then she had many more headaches, slow-to-no growth and she lost a few pounds so I asked them to test her for celiac disease. All tests were positive and a biopsy was done to confirm the diagnosis. We still have trouble with her health and don't know if there is something more we can do to help her. She is still very hard to keep stable and she doesn't feel her blood sugars going up or down so we test her all the time. Any suggestions?

Answer:

With such patients, I would work closely with a psychologist and make sure that the nurse educators see her at least monthly to help sort some of this out. Working closely with the team, if the celiac disease is contributing to instability or other vague and often subtle symptoms, then strict gluten avoidance should help a lot.

SB