Question from Hamilton, Ontario, Canada:

My 11-year-old daughter, who weighs about 42 kg (92 pounds), was diagnosed with type 1 in August 2006. We have had good blood glucose control since diagnosis and have enjoyed a lengthy honeymoon phase. Her daily total insulin needs have gone slowly, but steadily, upwards (about seven units a day in September 2006 to 15 units a day in February 2007 and to about 20-25 units a day from May through mid-August 2007). In the last two weeks, her insulin needs dropped dramatically and she has bottomed out at about 10 to 12 units of insulin a day for the past 10 days. She is happy and healthy and her blood sugar levels are good, but we are wondering what’s up. Our understanding was that insulin needs tend to go steadily upwards during the honeymoon phase until the body stops producing its own insulin entirely. This latest development seems contrary to what we’re expecting and maybe too good to be true. Do you have any thoughts on what might be happening?