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From San Antonio, Texas, USA:

My 11-year-old who has had type 1 for over seven years. Since diagnosis, his A1c has been climbing. Two months ago, it was at its highest, 9.2. Shortly after being diagnosed, my son starting having urine incontinence and ALWAYS had a belly ache. I mentioned this to our regular doctor, the endocrinologist and pediatrician, who said it was normal because he was so young. Now, he's 11 and in 6th grade. In the past 30 days, he has had accidents in class at school. I'm deeply concerned. Also, for the past six months, he has had a full belly and full bowels. The doctor did x-rays and confirmed twice that his abdomen was full of stool. We have just been giving enemas and Dulcolax. These do not seem to be helping. Last week, another issue came up. His right foot was killing him and he was limping, with one toe visibly swollen. The foot was painful to the touch. I took him to a different pediatrician and just spilled the beans about everything my son has been complaining about to me and what I have seen. She immediatly seem concerned and mentioned the words "diabetic neuropathy." Could this be what he is experiencing? I am feeling overwhelmed, hopeless, and I feel inadequate to my child's needs.


It is very unusual to have such problems at such a young age from diabetic neuropathy but the only way to know for sure is to work closely with your diabetes team, or get a second opinion from another diabetes specialist if you are not happy with your first team. For sure, the A1c levels you report are very high and this should be the top priority to make changes, work with the entire diabetes team to figure out the cause and involve your child in the solution. It all could be as simple as bringing the A1c to the 7% or lower range rather than as high as you report. But, there are several other conditions that also co-exist with diabetes starting at such a young age and these need to be considered, too. Celiac disease sometimes causes constipation instead of diarrhea. Gluten sensitivity without classical celiac disease also can cause such problems, vitamin D deficiency similarly. Thyroid problems and adrenal problems as well as other kidney and bladder problems are also possibilities. So, you will need someone to listen to these complaints and methodically, like crazy Dr. House on television, explore possible explanations. We always try to make one diagnosis fit everything but sometimes we have different things going on. When the urologist and the neurologist and the gastroenterologist all examine your child and then consult back with the diabetes team, them it may be possible to figure out all these complex problems and determine what else needs to be done. So, go back and ask them to start getting all these consultations done and report back to you what they discover. In the meantime, also please start working to bring the A1c levels downward since that can only help short and long term problems.


Original posting 5 Nov 2013
Posted to Aches and Pains and Complications


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