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March 20, 2005

Daily Care, Honeymoon

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Question from Saint John, New Brunswick, Canada:

Our seven year old son was diagnosed with type 1 in January 2005. He was on four injections a day. We were using Humalog for three injections and NPH at bedtime. After the first six weeks, we gave him his dosage based on his carbohydrates. He then began dropping low at times and then he got the flu, ate nothing and his sugars were in range, 5.0 to 10.0 mmol/L [90 to 180 mg/dl] without insulin.

He then decided he would not eat enough carbohydrates so he wouldn’t need any injections. His sugars had stayed in the 5.0 to 7.0 mmol/L [90 to 126 mg/dl] range, with no highs or lows. I called our doctor and he said our son is still producing insulin and if we wanted to, we could take him off insulin and see how he does. Well, it has been four days and his sugars haven’t gone over 5.0 mmol/L [90 mg/dl]. Is it possible he is not a diabetic and is able to control his sugars by diet? Or, is this the honeymoon period and the bottom will drop out any time? It has been only eight weeks since the original diagnosis. We were told he is still a diabetic and this might not last long. Could he overcome this and maybe his pancreas still work?

Answer:

From: DTeam Staff

It is most likely a honeymoon phase when the pancreas can make some insulin for some days or weeks, occasionally months. Most diabetologists think it is wiser to rest the damaged pancreas so that it does not have to overwork and thus prolong the honeymoon phase. So, most of us do not stop insulin completely at this stage. You should discuss this in greater detail with your diabetes team. You should also do some detailed pre- and post-meal blood glucose testing. The pre-meal values may be fine, but the one to two hour post-food blood glucose values may still be quite elevated, all the more reason to restart the insulin.

SB