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November 2, 2005

Honeymoon, Insulin

Question from Alberta, Canada:

How long is a child’s honeymoon and when will you know when that child is done honeymooning? Also, is there a certain amount of R and NPH a child should be talking at certain ages?


From: DTeam Staff

These are good questions and ones that you should not feel awkward about asking your diabetes team.

The amount of insulin a person requires obviously depends on many factors including their inherent sensitivity to insulin, their activity levels and their caloric intake. This is why meal planning and exercise are so, so important to the person with diabetes.

But, in general terms, it is not so much AGE that determines insulin requirements, but weight and also, in children, degree of pubescence. So, in broad terms, people with diabetes typically require, over the course of a day, about 1 unit of insulin for every kilogram that they weigh; so, I estimate anywhere from about 0.5 to 1.5 units per kilogram. If a child weighs 50 pounds (22.7 kg), I’d estimate a daily insulin need of 11 to 34 units, with an average of about 23 units, which again might depend on degree of puberty.

The diabetes honeymoon might typically last about a year or so. I think that I more typically see the honeymoon last about one and a half years. The longest I have seen is four years, in three different patients now. The shortest I have seen is about two weeks (in a teenage boy who did NOTHING that he was asked to do.)

If the child receives NPH and Regular, you will have a good idea when the honeymoon is ending because you will see higher glucose readings at lunchtime and/or bedtime.