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March 9, 2008

Aches and Pains, Daily Care

Question from Philadelphia, Pennsylvania, USA:

Our six-year-old son was diagnosed with type 1 around the age of 20 months. He has been on an insulin pump since he was three. After a recent stomach bug about three weeks ago, his insulin requirements have reduced dramatically. At first, we thought it was due to less food in his system but, once his appetite resumed, we are still experiencing reduced insulin requirements, except during the night. We have reduced his daytime basal rates and insulin to carbohydrate ratios during the day. Nighttime basal rates have stayed the same. He has been complaining his tummy hurts. His activity and other circumstances have remained the same. Do you have any thoughts?

Answer:

I would worry about celiac disease, Addison’s disease and thyroid disorders. These should be checked easily by your pediatric diabetes team. It would be rare for any viral illness to last quite this long but, sometimes, this also occurs and they could asses this as well. Stay in touch with them while you watch his blood glucose readings and adjust insulin accordingly. If all this turns out to be negative. it may just resolve more slowly with increased insulin requirement noticed by increasing blood sugar readings..

SB