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January 17, 2007

Honeymoon, Other

Question from Montauk, New York, USA:

My four-year-old daughter was diagnosed with type 1 diabetes in August 2006. She tested negative for antibodies and has been in the honeymoon phase since she came home. About two weeks ago, she got a virus that lasted about 12 hours. Her blood sugars stayed in the normal range, but she developed large ketones. Our doctor advised us on treatment and within 24 hours, her ketones were negative. Following the illness, her insulin needs kept going down. About a week later, we are now seeing extremely high sugars and have had to start using NovoLog instead of just NPH that we had been using. Is there any explanation why her body's insulin production would speed up and then start to diminish rapidly? Is this the end of honeymoon? She has a slight cold and her appetite is huge! Could she be having a growth spurt? Secondly, I am very suspicious of any products not recommended by a physician, but I keep running into people who either have diabetes themselves or have children with type 1 who are using a product called Mannatech. The product says it provides the body with eight simple sugars that we cannot get from food. The people to whom I have spoken claim that their child's control has improved greatly I want to know if this is a product that physicians have looked into and if it is safe to give to my child.


I’ve seen diabetes honeymoons last almost four years (in three or four different patients) and as little as two weeks in one teenage boy who did NOTHING requested of him. Most diabetes honeymoons, in my experience, last one to one and a half years, but six months is not unheard of.

Is she coming out of the honeymoon? Maybe. Does it matter? You need to give the insulin and follow the meal and activity plans as needed to keep the glucose levels in check, regardless.

Actually, I somewhat doubt that the insulin production actually “sped up” during the illness. More likely, her metabolism changed that week: perhaps her appetite was off; perhaps her intestines were not absorbing nutrients to the same degree; perhaps she “burned up” sugar during the febrile illness.

I’d simply go back to more insulin and if you find that her insulin requirements level off to a similar doses as needed before the illness, you will probably still be in “the honeymoon.”

Another way to look at this is that most children require one-half to a full unit of insulin daily for every kilogram of their body weight. If your child requires less than that, I’d conclude that they were still in a degree of a diabetes honeymoon. Your pediatric endocrinologist can guide you further.


[Editor’s comment: With respect to Mannatech, see our previous question on this subject.