A patient c/o "agonizing" pain once postprandials hit 140-150s, which has resulted in self-restriction of foods & beverages & unintended weight loss.  Cardiac issues have been ruled out.  Questioning gluten intolerances.  Any suggestions?

Suzanne,
I am curious about how they define "body pain". There may be a correlation but not causation with the blood sugars. Or, it may be a coincidence. It would be helpful to know what the blood sugar are when not in pain. Is the patient monitoring blood glucose fasting, pre-prandial, post-prandial or all? When are the 140-150's occuring in these testing time frames.
Is the pain in the abdomen or in the joints? Before you can consider a correlation with blood sugars, you need more information. As far as the pain itself, find out more info - location, description (stabbing, steady, radiating, local, general..etc). Diarrhea? Constipation? I wouldn't jump into the lake of intolerance issues until you figure out the bigger picture. A few things that come to mind are the fact that he/she is connecting the blood sugars with the pain, then avoiding food. Also, fibromyalgia pops into my mind as something to consider.
I hope that helps a little bit. Write back and let us know more info, or  what steps you took.
Good luck!