My daughter, diagnosed with type 1 diabetes about eight months ago, is only on about 25 units of insulin total per day. We caught her early, her blood sugar levels were never above 450 mg/dl [25 mmol/L], and she only had moderate ketones. Is it possible that starting insulin so early has “kicked” her pancreas to continue working? Might her demand never greatly increase?

Your daughter’s clinical history and insulin requirements, even though you don’t tell us about her age and weight, suggest quite probably she is in the honeymoon period and a C-peptide level will clarify this hypothesis. Ask your daughter’s diabetes team to do one if this hasn’t been done yet.

The honeymoon phenomenon is relatively common among young people recently diagnosed with type 1 and generally lasts shorter than few years as maximum with subsequent progressive insulin demand. It is due to some residual insulin production by your daughter’s endocrine pancreas. It is very important for her future outcome and to possibly prolong the honeymoon’s length that your daughter continues exogenous insulin therapy, even at a very low dosage, over this period of time.

MS