Our 11 year old daughter has been IDDM since she was 6. She has been well for five years, until the last few months when she started experiencing nocturnal vomiting with accompanying back pain, erratic blood sugar levels, and, more recently, nighttime hypo's. In the past 5 years, she has had only about 3 (minor) hypo's and only been hospitalized once as a result of a gastro type illness. This past few months have seen her back in hospital twice, re-stabilised, but then gets sick again.
Her pediatrician (who I have every faith in, but my husband is losing confidence in) has ordered a CAT scan, renal ultrasound and liver function, along with a myriad of blood tests, all which have returned negative. We are scheduled to take our daughter to the Children's Hospital in Melbourne next week for an EEG. Her pediatrician believes all this could be pre-pubescent hormonal activity and has ordered the EEG just to eliminate another possibility.
She is becoming distressed with all these illnesses and hypo's. She has recently started on 4 injections per day in an attempt for better control. However, after 3 weeks when all appeared to be settling, she has had 2 nighttime hypo's in a week, the 2nd very alarming where she took almost one hour to "come out of it". I have taken to setting my alarm at 12 midnight to check her blood sugar levels: her 9 P.M. blood sugar level can jump from 26.0 (our readings are different to yours, I think) to just 2.3 at midnight. I have given her something to eat, then her blood sugar level jumps back up to the high 20's at 7:30 A.M..
After 5 years of good control and very few problems, we are beginning to despair. Whilst I continue to have every trust in our pediatrician, a second opinion from someone with your experience would be very welcome.
It would be nice to say that I know what's going on with your daughter, but this isn't possible. It is not uncommon for things to get difficult around puberty and it can be very frustrating trying to find a regimen that works. However, I think that it is quite a good idea for you to seek a second opinion. Quite possibly, this will not result in some inspired diagnosis but I think it would restore confidence in your paediatrician. Unfortunately medicine on the Internet doesn't allow examination of patients so it would be folly for me to say more.
Additional comments from Dr. John Schulga:It may be worth checking thyroid and for coeliac disease just to at least exclude these as a cause for the change in control.
Original posting 15 Jan 2000
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