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Diagnosed with type 1 diabetes. Having pain in abdomen. Has insomnia. Prescribed Ambien. Suggest

Jan 2013
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Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
My 30-year-old daughter was diagnosed with type 1 diabetes in March. Since then she has severe pain in the middle of her abdomen (about 1 1/2 inches above and below her belly button, and about four inches on either side of the belly button. It comes on suddenly. She has insomnia now and only gets about 2 hours of sleep each night. Also, she has sharp, burning pains in the backs of her legs. The doctors say it is not neuropathy and they don't have any answers. She has lost her appetite and about 10 pounds since the onset of the pain. She is very depressed and cries all the time. She weighs 116 and is 5'7". Her diabetes is under control with insulin. We have seen two endocrinologists and one Internist. She has gotten weaker because of no sleep. She was prescribes 800 mil of Tylenol, doesn't touch the pain. Also, prescribed Ambien for sleep, doesn't even make her drowsy.
Posted Sat, 8 Jun 2013 in Diabetes
Answered by Dr. Mayank Bhargava 8 hours later
Welcome to XXXXXXX forum.

Let me know the associated symptoms along with mentioned.
Does she has acidic belching/ abdominal bloating/ excessive flatulence/ constipation/ diarrhea?
Does she has yellow discoloration of eyes and urine/ abdominal distension.
Does abdominal pain gets worsen after taking meals?
Is she smoker or an alcoholic?
Does she has the similar abdominal radiating to back?

With the available described details, there appears to be possibility of gall stones, pancreatic disease i.e. pancreatitis, and peptic ulcer disease.
Recently diagnosed diabetes with abdominal pain is considered as highly specific for pancreatic disease and pancreatitis & pancreatic tumor must be ruled out.

Abdominal pain which gets worsen after taking meals are related with peptic ulcer disease, cholecystitis and pancreatitis.
Peptic ulcer disease may manifest in form of acidic belching, abdominal heaviness and bloating, gargling sound , excessive flatulence.
Peptic ulcer disease could be due to Helicobacter pylori bacteria and could manifest in form of nodular gastritis, follicular gastritis, erosive antritis, gastric and duodenal ulcer disease and in severe cases, may cause adenocarcinoma of stomach.

You should consult with XXXXXXX medicine specialist/ gastroenterologist and should go for thorough check up with all past reports.
She should also go for complete blood count, serum amylase and lipase, serum electrolytes,and thyroid profile, x XXXXXXX spine, nerve conduction studies of both lower limb and ultrasound imaging.
She should also go for CT/ MRI scan abdomen for better clarification.

If all these relevant investigations are found to be normal then she should also go for endoscopy along with biopsy and urea breathe test for H. Pylori.
If Urea breathe test is found to be positive then you have to take complete eradication therapy for H. Pylori bacteria. Endoscopy will also make confirm the presence of peptic ulcer disease.

Treatment depends on exact diagnosis.
Meanwhile, she should also take proton pump inhibitors along with prokinetics.

She should follow the mentioned changes:
1) Don't take tomatoes, and citrus fruits.
2) Avoid onion, garlic, excessive tea and coffee, chocolates,
3) Avoid oily and spicy food, non veg.
4) Take soft diet along with yogurt.
5) Keep difference of 3 hours between meals and sleep.

Hope that helps.
Let me know your other query.
Take care,
Dr. Mayank Bhargava
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