Understanding the Honeymoon Period in Type 1 Diabetes

Dr. Fran Cogen Health Pro December 08, 2009
  • Many questions/comments appear on this site in regard to the honeymoon period:   1. What is it? 2. How do I know I am in it? 3. How long will it last? 4. How do I prolong it? 5. Do I need to continue insulin if blood sugars are in range? 6. Is it better to be out of the honeymoon period s...

6 Comments
  • Ginger
    Jan. 10, 2011

    My son was dx on May 28, 2009, just three weeks before his ninth birthday.  His bg was 323, and he had only trace ketones.  He started insulin immediately.  We did 15 units of Levemir and a 1/15 ratio for the first six months.  After that, we started on a pump.  He currently takes .65-.95 basal throughout a 24-hour period.  His...

    RHMLucky777

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    My son was dx on May 28, 2009, just three weeks before his ninth birthday.  His bg was 323, and he had only trace ketones.  He started insulin immediately.  We did 15 units of Levemir and a 1/15 ratio for the first six months.  After that, we started on a pump.  He currently takes .65-.95 basal throughout a 24-hour period.  His ratios are 1/14 for breakfast and lunch, 1/13 for dinner. We rarely fluctuate above 200 or below 70.  His A1c is always between 5.8-6.0. 

    I would estimate his average daily dose to be 35-40 units.  He is also extremely active, playing competitive baseball and basketball year round.  He eats just about anything he wants without a lot of fluctuation, but I think a lot of this is due to so much activity.  How do I know if he is honeymooning or not?  

    • Dr. Fran Cogen
      Health Pro
      Jan. 12, 2011

      Hi Ginger: Firstly, we may never actually be sure if your son is still in the honeymoon period. The clues are as follows: if your child's total daily dose of insulin is less than 0.6 units/kg, along with minimal fluctuations of blood sugars (tight control with few peaks and valleys), along with the ability to have a large amount of carbs without high blood...

      RHMLucky777

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      Hi Ginger: Firstly, we may never actually be sure if your son is still in the honeymoon period. The clues are as follows: if your child's total daily dose of insulin is less than 0.6 units/kg, along with minimal fluctuations of blood sugars (tight control with few peaks and valleys), along with the ability to have a large amount of carbs without high blood sugars, it is possible that he is still making some of his own (endogenous) insulin and therefore hanging own to his honeymoon period. One can also measure a "c-peptide which determines the amount of insulin that is still being made by the body. Sometimes, it is hard to tell. But, even so, clinically, I would just provide exogenous (or shots/pump) and keep those beta cells pumping as long as possible.

      Hope this helps,

      Dr.Cogen

  • Anonymous
    Chris
    Jan. 14, 2010

    Dr. Cogan,

     

    I am now 32 and have been in the honeymoon phase for 4 years.  I have auto-immune issues.  With that in mind,  I have been on the same medicinal regimine of 15u of Lantus in the AM and 1 5mg of Glyburide since I was diagnosed. I have never taken short-action insulin and my last two A1C numbers were 7.1 and 7.5.

     

    I am 6'1"...

    RHMLucky777

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    Dr. Cogan,

     

    I am now 32 and have been in the honeymoon phase for 4 years.  I have auto-immune issues.  With that in mind,  I have been on the same medicinal regimine of 15u of Lantus in the AM and 1 5mg of Glyburide since I was diagnosed. I have never taken short-action insulin and my last two A1C numbers were 7.1 and 7.5.

     

    I am 6'1" and 205lbs... I do not excerside much at all (I would like to improve), but watch what I eat very well.  Luckily, since my diagnoses, my stomach doesn't allow me to eat near as much as when I was younger.  I do avoid candy and all sweets, but drink about 3-4 glasses of Chardonney each night.

     

    Given the longevity of the honeymoon phase, is there a chance that it is Type 2?  That would be a blessing.  Is there a test for that?

     

    I have heard that the honeymoon phases generally lasts around 1-4 months or a little longer.  Given the above, would you say that I am still in the honeymoon phase?  If so, is this kind of a miracle?

     

    Thanks for all of your insight!

     

    -Chris

  • Anonymous
    Denise
    Dec. 21, 2009

    My son was diagnosed 08/2007, he took teplizumab (an anti CD3 Monoclonal antibody) to stop the autoimmune attack 10/2007.  By Thanksgiving - we could not give him any insulin.  He spent 18 months without insulin - He just had to start taking it again 04/2009 - He still does not take a lot but when his numbers started creeping up (interestingly, after...

    RHMLucky777

    Read More

    My son was diagnosed 08/2007, he took teplizumab (an anti CD3 Monoclonal antibody) to stop the autoimmune attack 10/2007.  By Thanksgiving - we could not give him any insulin.  He spent 18 months without insulin - He just had to start taking it again 04/2009 - He still does not take a lot but when his numbers started creeping up (interestingly, after a bout of mild pneumonia) we started adding insulin and just this fall went back to the Levemir at night - 15 units.  He takes about 15 - 20 units of Novolog per day before meals and with snacks as well.  He weighs 140lbd and is 5'9".   He is also entering puberty (turned 12 in August). 

    He eats very well and gets lots of exercise because he is involved in many sports.  

    He doesn't have wild fluctuations in his blood sugar.

    I hope they continue this research.    I think the most important advice for a long honeymoon is to treat the body well which includes eating the right foods and exercise.  I am so tired of all of the parents of that say they don't want to restrict their children with diabetes from eating the foods they want, "let a kid be a kid".  I don't see why children can't be happy without sweets. I'm not saying we have to completely deny them but we must learn to say no and have these kids learn to make healthy choices about their diets. 

     

  • Anonymous
    Mom of Type 1 boy
    Dec. 14, 2009

    My son is still in honeymoon after 1 1/2 years - I have wanted more info about how to tell when it's ending, etc.  We notice his numbers are much better when he gets regular vigorous exercise, so not sure if that's part of why he's still in it.  His insulin requirement is about 1/3 what his doctor expects for his size. We're thankful for...

    RHMLucky777

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    My son is still in honeymoon after 1 1/2 years - I have wanted more info about how to tell when it's ending, etc.  We notice his numbers are much better when he gets regular vigorous exercise, so not sure if that's part of why he's still in it.  His insulin requirement is about 1/3 what his doctor expects for his size. We're thankful for the extra time in honeymoon. Thanks so much! 

    • Dr. Fran Cogen
      Health Pro
      Dec. 14, 2009

      So glad that your son appears to be producing some endogenous insulin. Vigorous exercise increases insulin sensitivity which helps to lower blood sugars more efficiently: thus also contributing to the need for less exogenous insulin (shots). He should keep exercising regularly..it truly helps.

      Happy Holidays