Question from Wichita, Kansas, USA:

My son was diagnosed with type 1 diabetes January 2004. He has been in a honeymoon stage, only needing moderate dietary care and 24 hour Lantus injections to keep his blood sugars well on track. His A1c has been within the normal range for persons without diabetes since his diagnosis. SUDDENLY, his insulin needs have changed and have not followed the patterns we’ve noted and gotten to know in the past. We have had to slowly increase the amount of Lantus from 13 units per day to 17 over the past week and a half, more than he has ever taken, even when ill. In addition, we had have to use approximately one unit of NovoLog per every 50 mg/dl [2.8 mmol/L] we want to lower his blood sugar and one unit for every 15g of carbohydrates he ingests, as best as we can figure.

He seems to be in a growth spurt, and we did let him eat a some higher carbohydrate meals during the holidays, adding NovoLog as we felt he would need it. I’m worried that we have ended his honeymoon period by letting his diet become more liberal with sugar, an occasional slice of Thanksgiving pie, etc. This saddens me, although it may have no basis in fact.

He was examined by the general doctor yesterday, as his ear canal looked red. The doctor said it was red, but the drum was not infected, and did not feel he needed an antibiotic. I thought this might have explained the recent need for more insulin. His teeth look okay.

I cannot reach his pediatric endocrinologist, but our appointment is this week. Does the honeymoon period normally end abruptly, quickly and dramatically increasing the doses of insulin needed? I was under the impression it would be a more gradual progression that we could adjust to as it came.