February 17, 2006
Honeymoon
Question from Princeton, New Jersey, USA:
My 17 year old son was diagnosed with type 1 diabetes three weeks ago. His blood sugar was 795 mg/dl [44.2 mmol/L] when he was admitted. His insulin level was 3. Due to the very high glucose, the endocrinologist felt he has lost all his insulin-producing cells and would not have a honeymoon period. But, two weeks post diagnosis, his glucose levels began falling and falling and the insulin he required was much less. He went from needing 80 units per day with the pump to only 50 units per day (he is 6 feet, 2 inches). It sounds like a honeymoon to me, but the doctor seems reluctant to call it that. He did not have any antibodies, by the way. He is thin and his C-peptide level was low. Do you feel this is the honeymoon phase? I hope that it is and that it lasts forever. I have read that people are better able to control their sugars during the honeymoon. Are there any documented cases of people with type 1 having some permanent level of islet cell function, even years later?
Answer:
Your wishes for an eternal honeymoon are common but, unfortunately, not likely. However, one cannot predict honeymooning very well even using insulin levels, antibody levels and C-peptide levels. Blood glucose levels reflect whether there is some residual insulin or not much more realistically. And, tight control of blood glucose, in some research studies suggests that this helps the honeymoon phase to occur and to be more prolonged. In any case, all such decisions should be made with insulin adjustments based upon actual blood glucose readings and not dogmatically so that each individual is treated as an individual with appropriate goals. Keep working closely with your diabetes team and they should be able to help you sort this out. The goal should remain the best glucose levels possible without excessive or severe episodes of hypoglycemia.
SB
