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Question:

From Sheffield, UK:

Our five year old daughter has had insulin dependent diabetes for one year. She is generally well controlled. The problem is that she has had a couple of bouts of distressing pains in her lower limbs, which she localises to her ankles. They seem to be focused on the ankle joint area, but extend to around the mid shin, and down to mid forefoot. This seems to come on when her sugar is falling quickly, and possibly after she has been running higher than usual. She also has hyperaesthesia at the same time. Our impression is that a boost of short acting sugar stops the worst of the pain, which then gradually wears off. This pain can come on when her sugar has dropped fairly rapidly, e.g, from 14 to around 6 but it does not have to be low enough to cause hypo problems. This has now happened several times, and is very distressing for her and very difficult to handle for us.

Are we seeing something that is (a) anything to do with her diabetes; (b) been described before; (c) actually to do with these sugar level drops, or are we off target? We are worried and mystified.

Answer:

Pain is not a common symptom of low blood sugar, but low blood sugar can cause any neurological symptom. If you feel that these symptoms are associated with low or dropping blood sugar and disappear with treatment of the low blood sugar, it is unlikely that your child has any other problem. My advice would be to reassure your child that these pains are not serious and to talk to you doctor about ways to try to avoid low blood sugars or rapidly falling blood sugars. If the pains come unrelated to low blood sugars, or if you child starts to limp or develops swelling or redness of the joints, you should look for other problems either unrelated to diabetes or problems more common in children with diabetes such as juvenile rheumatoid arthritis. It is highly unlikely that your child has developed neuropathy, a long term complication of diabetes.

TGL

Original posting 20 Dec 97

  
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Last Updated: Tuesday April 06, 2010 15:08:56
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