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Honeymoon Question

Discussion in 'Parents of Children with Type 1' started by AmandaF, Sep 2, 2013.

  1. AmandaF

    AmandaF Approved members

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    Hey all
    I seem to be a little confused about the honeymoon. Does the honeymoon start at DX or does the honeymoon take some time to kick in? DS was dx July 15th and I thought that the honeymoon just started then. However, since Friday DS has been constantly running low. He is averaging between 60-80. Before Friday we could keep him anywhere between 90-175 (average).

    He has never really experienced anything below 60 until this weekend so now my panic of the "Low's" is really kicking in. Anyone have any advice? I am thinking that I should maybe cut back on his insulin to carb ratio. He is now doing 1:12. Do you think I should maybe up him to 1:15 and go from there? He also is taking 16 units of Lantus @bedtime.

    Any advice would be wonderful!!! Thanks!!!!!
     
  2. Sarah Maddie's Mom

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    No, the "honeymoon" refers to a phase when the islet cells are getting enough "support" from the injectable insulin and they sort of rally for a time. So, no, it begins sometime after insulin therapy begins.

    That said, your son's basal and carb ratio see really really high for an 8 year old. Is he very big for his age?

    As for specific changes I think you really should check in with your endo since it's still early days.
     
  3. Lizzy731

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    Bethany's total basal is just under 9 units of novolog and I/C ratios range from 11-23 throughout the day. She is 9 and very tall for her age. I don't know how lantus converts to novolog in a pump but it does seem high. The I/C ratio doesn't seem that off but Bethany needs less insulin for meals later in the day. I was told by CDE that Bethany needs a little less insulin than most kids her age though.

    That all being said maybe its the lantus that is the issue??
     
  4. AmandaF

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    He is maybe 2 inches taller than most of his friends but he doesn't have a weight problem.... He is almost 9 and about 49 inches and 67 lbs.... So I think that his weight is a little more than most but he is not fat..... he is very muscular...
     
  5. Lizzy731

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    Bethany is 56" and 80 lbs!
     
  6. hawkeyegirl

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    My son is 9, 61" tall and weighs 90 pounds. His basal and ratios are very similar to your son's...at a foot taller and 25 pounds heavier. So yes, your son uses a LOT of insulin for his size.

    If I see around the clock lows, I decrease the basal. I'd take the Lantus down to 15 units and see what happens.
     
  7. quiltinmom

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    I really think you need to ask your endo or CDE before changing ratios or lantus. Being so newly diagnosed, I think it's better to get specific help from your health care team. Just so you know, you can't really compare total daily doses with other kids. It's just going to be different for other kids, even if their weight, height, and age are the same. There are guidelines of what might be considered normal for people of certain ages, but during the honeymoon, those don't really apply. Even after the honeymoon, it's still just that--a guideline.

    That said....my DS had a pretty big dose decrease a few weeks after dx. I can't say if that's common or not, but it happened for us.

    Good luck! :)
     
  8. Helenmomofsporty13yearold

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    I would reduce the lantus tonight and call your clinic tomorrow. DD's basal needs kept falling during her honeymoon down to only 1 unit of basal 6 months in.
     
  9. Mish

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    I'm another who thinks it's a ton of insulin for a child that size . I think what you're seeing is that early on he needed a lot to get his BGs back in some sort of range, and now you're going to be pulling all that insulin back into what will become a more normal Total Daily Dose.

    To get his TDD; TDD = all the food injections for the day + any extra corrections + 16 units of lantus.

    The normal guideline is that anything over .5u of insulin, per kg of weight, is "out of honeymoon". Your child weighs 30kgs and is already taking more than that in basal alone. I would guess, just based off your ratios, that he's taking close to 1u of insulin, per kg in weight, per day. Teen boys in puberty take around that much, and more. It's VERY unlikely that your 8 year old, normal sized boy, needs that much insulin right now.

    So, while I wouldn't actually call it a honeymoon, I think what you're seeing is that his body, now that it's more in range after diagnosis, knows what to do with the insulin you're giving him and is just using it effectively. It probably will be the beginning of a series of drops in insulin until he's down nearer to 15-20u TOTAL for the day.


    I wanted to also add, at dx my son was taking about 12u of basal per day. Within a few months he was down to about 2u. He slowly increased in a normal rate over the years as he grew, but it took years and years before we ever took that much basal again. :)
     
    Last edited: Sep 2, 2013
  10. Debdebdebby13

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    It's normal to use significantly less insulin a few weeks after diagnosis. My DD was only 5.5 at diagnosis, but she started out on 3u of Levemir and a 1:30 carb ratio. When we got to the strongest point in her honeymoon she was getting .5u of Levemir and her carb ratio was 1:60. Most days she was getting 3-4u/day total. At that point she was around 45-46" tall and 53lbs or so.

    Now she's not honeymooning at all, is 7 years old, 51" tall, 60lbs and uses 18-20u/day total.
     
  11. sincity2003

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    My son is the same age as your son.....is 57" tall and weighs 80 pounds. That's a lot of insulin! I know when we first came home from the hospital his doses were pretty high...and at our fourth appointment (which was the 8 week mark), they dropped off pretty significantly. We were doing NPH and R with the syringe, so DS was very happy. He stayed in the honeymoon period until the beginning of June (we believe). In June and July he was getting a lot more insulin, but then in August we switched to MDI.
    He now gets 12 units of Lantus at bedtime, breakfast is 1:15 and the rest of his day is 1:20, which was all changed last Monday (he was getting 10 units of Lantus and 1:20 all day long).

    Being that you're only 6 weeks out, I would follow your plan that you currently have until you can get your CDE on the phone. His body is still changing and you don't want to all of a sudden spike highs because you changed something. Also, I believe you said he plays baseball....has that started yet? Baseball was when we always had lows last season. This season (it's already started for us), he's tracking normal (95-100 range), but just wanted to give you that heads up too.

    Good luck! :)
     
  12. AmandaF

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    I will call the endo in the morning...... I know in the very beginning we couldn't seem to budge him below 300 so the amounts kept going up.... It seems that maybe, like someone else said, that it's all just kind of kicking in now and he needs much less insulin..... Thanks for all the advice.... Ill let you know what our Endo say... lol
     
  13. wearingtaci

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    He is the same size as our teensy almost 11 year old. To me it seems like a lot of basal. Sophie has an I/c ratio of 10:1,but only gets 11 units of lantus at bedtime.
     

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