My son is 2 years old. A month ago, we detected all symptoms of diabetes and went to hospital. He had a 414 blood glucose and ketones in his urine. He was walking and lucid. He was in the hospital for 4 days and now he needs only 4-5 units/day of NPH insulin. Is this the period called the “honeymoon?” What can we do as parents to preserve the rest of the islets that are still working?

I am sure from your comments that your small son has Type�1A (autoimmune) diabetes and that he is indeed in the honeymoon period. Over the years there have been many attempts to prolong this phase. A drug called cyclosporine had some success, but it was later found to cause kidney damage. So far as I know, none of the new immunomodulatory drugs have been tried. This lack of success is not surprising because it is now known that by the time someone becomes insulin dependant over 90% of their insulin producing cells have been destroyed.

The best thing you can do now is to learn with the help of his doctor and the nurse educator in the diabetes team to keep his blood sugars as near to normal as possible without producing hypoglycemia, not an easy task in a two year old. With new insulins like Lispro and Glargine, new fine needle and essentially painless blood sugar assays, however the task is now a little easier.

If you have or might have other children it would be worth testing them for antibodies because it has been shown that at this early stage insulin dependency can really be deferred for years by the use of either nicotinamide or insulin itsel but, again, you do need to talk to the doctor about this.

DOB