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February 10, 2009

Aches and Pains, Sick Days

Question from Norwalk, Ohio, USA:

My 13-year-old son was diagnosed with type 1 four years ago. He uses an insulin pump to treat his diabetes. The week after Christmas, he got what we thought was a viral infection/stomach flu with diarrhea and low fever. The runny diarrhea lasted about a week, but loose stool after that for six weeks. His blood sugars have been all over the place, but never any ketones. He has recently started to throw up also and sleep a lot. He has had stomach pains, too, and complains constantly of a stomachache. He throws up all the time, mostly in the mornings. Has no energy. He still goes to the bathroom at least five times a day. He drinks a ton of liquids, is always thirsty. His appetite is great on some days and not so good on others. He has had blood tests (all with inconclusive results), a test for celiac that was inconclusive, and is scheduled for an upper GI next week. We have seen his endocrinologist and a pediatric gastroenterologist. No one can help me!

My son has missed five weeks of school! Some days are better than others, but I am so frustrated. Something is wrong and we just can’t find out what. Do you have any suggestions? The doctor is considering an EGD (esophagogastroduodenoscopy) and a stomach biopsy, but we can’t get an appointment until February 20.


From: DTeam Staff

You indicated that some testing for celiac disease was inconclusive and that your son is scheduled for additional testing with the pediatric gastroenterologist. It sounds as if you there are professionals trying hard to get to the bottom of this. I have little else to offer until you learn more.

Has there been any unusual travel for him? Has he been camping outdoors?

You might try some probiotics for symptomatic relief, but I would run that by your pediatric gastroenterologist first.

I also would want to assure that the negative ketone checking you are getting is valid. Given all that you discuss, I could see where ketones could start and certainly that could cause vomiting. So, while I am glad that you have checked for ketones, why don’t you open a new bottle and just confirm? If positive, talk to your diabetes health team.

Good luck and please let us know what you find.


[Editor’s comment: Although you did not indicate how you were checking for ketones, we recommend blood ketone testing. See our page on Hyperglycemia and Blood Ketone Testing.