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May 31, 2001

Honeymoon, Insulin Pumps

Question from Puerto la Cruz, Venezuela:

I am 20 year old, and was diagnosed with type 1 diabetes just two months ago, and I am in the honeymoon phase. Would you recommend the insulin pump now? What are the pros and cons of starting the pump during the honeymoon phase?

Answer:

The honeymoon phase refers to a period of decreased insulin requirements after the initial diagnosis of type 1 diabetes. The decreased insulin requirement is the result of improved function in the native beta cells that are still left functioning. It is generally felt that the better you control your sugars during the honeymoon phase, the longer it will last. However, this does not always require an insulin infusion pump. Most of our patients can be treated well with small amounts of subcutaneous insulin. When your insulin requirements begin to increase, you can work toward the pump, if you like. The pump remains an effective means of delivering insulin with maximum flexibility.

JTL
Additional comments from Dr. Stuart Brink:

You should ask this question to your diabetes team and doctor(s) since they know a lot about you already. Usually one does not use an insulin pump so soon after diagnosis. Most recommendations are for using insulin pumps when multiple insulin injections are not controlling the glucose levels well.

During the early stages of diabetes, the pancreas may be able to make some insulin and this is the so-called honeymoon phase. It does not automatically happen, but, in 20 year olds with type 1 diabetes it can often last for quite some time with reasonable insulin doses, monitoring and dietary planning.

If one is not meeting one’s blood glucose goals, having excessive hypoglycemia, having problems with overnight control of glucose values, then an insulin pump is an excellent way to deliver insulin.

SB