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Could also be something in the differential. I used to have an 03 Sierra that made a similar sound and ended up being the rear pinion gear. That may be why you don't hear it until you get around 40mph, as the gears don't get moving fast enough so you hear the noise in the truck.

I've got an 04 Yukon with 40k that does not want to start when low on fuel (less than 1/4) and sits for more than 8 hours. Just cranks and cranks. It will run fine at a low level and start right up with in a few hours of being shut off. When it doesn't start if I put a few gallons in it will...