December 13, 2000
Honeymoon
Question from Sunnyvale, California, USA:
I am a 38 year old male diagnosed with type�1 diabetes two months ago, after being admitted to the hospital for DKA [diabetic ketoacidosis]. My blood sugar level was about 500 mg/dl [ 27.8 mmol/L], and my HbA1c was about 10%. I was on 12 units of NPH and 6 units of Regular insulin for about a month. After about two weeks, my blood sugar levels stabilized below the 200 mg/dl [11.1 mmol/L] range, but, my pre-lunch levels were very low, in the 40-60 mg/dl [2.2-3.3 mmol/L] range. I have cut down on the insulin gradually to about 1 unit of NPH twice a day, and my pre-lunch levels were still low, in the 50-70 mg/dl [2.8- 3.9 mmol/L] range. Now, I am completely off of insulin, and my blood sugar levels have stayed normal. The latest results for HbA1c was 7.8% and fasting glucose was 113 mg/dl [6.3 mmol/L[. I am on a high fiber, low carb diet and have been exercising regularly.
Is is usual for somebody in the honeymoon stage to be able to get off of insulin completely?
Answer:
The usual situation during the honeymoon period is that a person with diabetes can get by on less insulin than they initially took to get under control with diagnosis of the condition. The fact that you were able to get off insulin all together is great! It doesn’t always happen that way. I would caution you that the best way to maintain the honeymoon is by maintaining the best sugars. If this means taking a small amount of insulin to prevent need for larger doses, then I would be in favor of taking the low doses of insulin.
JTL
[Editor’s comment: It is possible that you have type�1B diabetes in which case, you may only require insulin intermittently. A distinction can be made between type 1B and type�1A (autoimmune) by testing for antibodies. However, these tests are expensive, difficult to do properly, and may not change treatment. The important thing, as Dr. Lane suggests, is keep your blood sugars in good control to prevent long-term complications.
SS]
