As EMom says (thanks, EMom), total enteral nutrition is an alternate treatment option for people with Crohn's who don't want to use steroids. It is particularly effective for children. Here are a couple of references:
There are several types of formulas that are used for enteral nutrition, elemental, semi-elemental, and polymeric. For a child with diabetes, your best choice would probably be a polymeric formula, since you can find some with a relatively high ratio of fats to carbohydrates. But I'm not a diabetes expert, so the particular choice of formula would be best left your doctor. I hope your grandson feels better soon.
My 17 year old daughter has had type 1 diabetes since 2000 and was diagnosed with Crohn's disease on June. She was in the hospital 2 weeks after diagnosis of Crohn's after starting Pentasa. She had extremely mild Crohn's at diagnosis. Within two weeks of being on the Pentasa, she was diagnosed with moderate Crohn's. The medicine made her Crohn's worse, which I guess sometimes happens. Because of her diabetes, they skipped over the steroids and put her directly on Remicade. Unfortunately, she can't go the 8 weeks that they wanted her to, so they have bumped it to every 6 weeks. She was admitted to the hospital on 1/13/09 with a Crohn's flair. They gave her Remicade exactly 1 month after her last dose. The hospital she went to which is supposed to be the best in the Northwest can't handle the fact that she has Crohn's and Diabetes. They did everything wrong - giving her sugar water, not checking her blood sugar, letting her eat. She ended up with a fever, high blood sugar, and fought with us about giving her any pain medication. This is supposed to be the best hospital around and I've had two very upsetting experiences with this hospital and its staff. The doctors didn't even talk to me until I demanded it. I had to request a pain consult from the pain clinic and they ignored my request for 24 hours. My daughter was suffering. I understand that pain meds cause the bowels to slow down, but I also understand that massive stress can cause or exacerbate the flair.
The other thing that is frustrating is the everything you are supposed to eat when you have diabetes is something that is almost always off limits or you should avoid with Crohn's. If anyone is out there that has both these diseases and knows a great internal medicine specialists in Western Washington that has experience with both of these diseases, I would appreciate any information. She also has hypothyroidism and asthma. Her diabetes has been uncontrolled since diagnosis - lovely hormones during these teenager years.
What type of pain meds can be taken that work and don't hurt the GI system? She was let out of the hospital on Friday with a blood sugar level of 363 and has been in a lot of pain with 10 oxycodone over the long weekend. Can't get in to see anyone until Feb. 5 even though discharge notes say to see doctors within 3-5 days. Any suggestions?