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September 29, 2001

Honeymoon

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Question from Fremont, California, USA:

My friend’s 11 year old son was recently diagnosed with type 1 diabetes, is currently in the honeymoon period, and his father is curious as to what he can do to prolong this. Are there any scientific studies as to types of foods, herbs, diet changes, exercise, etc., that can prolong it?

Answer:

From: DTeam Staff

By the time that type 1 diabetes has been diagnosed, over 90% of the beta cells’ ability to produce insulin has been destroyed. It is not surprising therefore that the many attempts to prolong the honeymoon period have so far been unsuccessful.

At one time it looked as though the drug Cyclosporin might be an answer; but in the end, it proved toxic to the kidneys. Just the same, further trials are being made using some of the newer immunomodulatory drugs. However, it might be worthwhile for your friend to discuss with the doctor whether it would be appropriate to get an antibody test done. In all probability that has already happened and was positive, but if this was not the case and especially if the boy comes from a Hispanic or African American family, a negative test would suggest type 1B diabetes and a significant possibility of being able to do without insulin in the coming weeks. If he is of Caucasian background, then this possibility is only around 5%.

Herbal approaches may have a placebo effect for the father, but are otherwise of no use. Adapting to the routine of diet, exercise, glucose monitoring and insulin is of great importance.

DOB
Additional comments from Dr. David Schwartz:

Several years ago there was a very interesting article published from the University of South Florida in the New England Journal of Medicine
describing how when newly diagnosed patients in the investigators’ protocol were
hospitalized, and hooked up to a Biostator (a refridgerator-sized device
that can infuse large amounts of insulin and glucose, depending on the blood
glucose level –the precursor to a mechanical pancreas) for a few days, on
a yearly basis, many patients had prolonged honeymoons and some actually
had reversion of their pancreatic antibodies from positive to negative.
This was very encouraging, and in some ways, was part of the thinking behind
the recent DPT-1 trial. But the DPT-1 trial has disappointingly given
negative results. Nevertheless, I would underscore Dr. O’Brien that attention to
the 3 main prongs of diabetes managment, with a willingness to “push” the tolerability of insulin in patients, seems to prolong the honeymoon in
many patients I have worked with.

IDS