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February 12, 2004

Honeymoon

Question from Jamanager, Gujarat, India:

My child is 4 years old. She has had increase in her diabetes during the last four months. She is recovering fast and twice she had hypoglycemia with a blood sugar of 42. Now she has her serum insulin report (fasting) of 23.6 mg/u, and blood sugar was 212 on 30th January 2004. As her body has started producing insulin by itself now, why is her blood sugar still high? We consulted with the child specialist and he told us that the might be a problem or a complication in her body otherwise it wouldn't be like this. Can you send me information about the complications like this and any treatments? Is it possible that the diabetes could be removed from her body forever?

Answer:

Although I cant be quite sure without some more information, I think that your daughter is most probably passing quite normally through what is called the ‘honeymoon period’ in Type 1A Autoimmune Diabetes. This commonly occurs a few weeks after the onset of insulin dependant diabetes and is accompanied by some restoration of the subjects ability to produce their own insulin. It may last several months; but after that time insulin by injection is again required. In your daughter’s case, I think that insulin may have been discontinued, perhaps because of the one low blood sugar and the low normal serum insulin. However the amount of insulin that she herself was producing was not quite enough for the amount of carbohydrate in her diet and this was why she had a blood sugar of 212 mg/dl. There is a great deal to learn about Type 1 Diabetes and you might get a lot of help by reading some of the Chapters of Understanding Diabetes by H. Peter Chase, MD, especially Chapter 3, which is about type 1 diabetes, and which can be downloaded without charge. I am sorry to say that I think that it is very unlikely indeed that she no longer has diabetes and I suspect that small doses of insulin are in fact still required and that these will increase again in time.

DOB