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How long does the honeymoon last and how do you know it's ending?

Discussion in 'Parents of Children with Type 1' started by dshull, Dec 12, 2012.

  1. dshull

    dshull Approved members

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    I know that this is different for everyone, but I am curious how long this might last. Our son is 7 and is definitely in the honeymoon phase. They recently took him off of the Levermir entirely, he only takes Novolog now. Most days he does not take more than 5 units per day for food coverage.

    I have heard that sometimes right before the honeymoon ends, their insulin needs drop dramatically and then one day they rocket back up and that's how you know it's over. He has been running on the low side the last few days so I am curious what other people's experiences have been.

    And for those of you done with the honeymoon, is it harder before or after? I like knowing that his body is still working somewhat and so I would like to keep it going as long as possible.
     
  2. wilf

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    Your first clue will be when you have to reinstate the Levemir..

    Different families have different experiences with the honeymoon. We found things to be much easier, and I agree if that is the case then you want to make it last as long as possible.

    Best way to do that is to do you best to keep him in range. Exercise and diet play a key role.

    Good luck! :)
     
  3. mysweetwill

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    We are a year in and my son is still honeymooning, evidenced by his c-peptide and low insulin needs (he is 11, he takes 8 units or so per day). There have been periods since he was diagnosed when he needed no insulin, periods when he needed no more than .5 unit of lantus and periods where his insulin needs have increased. He had a stomach bug last week and has been running so low that he has not needed any boluses for food since.

    I have read some people had a difficult time with the honeymoon and want it to end. For us, the help his pancreas is providing has helped us manage his BGs better. I have asked how we can prolong this honeymoon and the only answer Im given is tight control.
     
  4. tiger7lady

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    I figured it out in retrospect. After about a 1 1/2 years I realized over the course of 3 months his insulin needs had doubled. I just kept raising his basal and adjusting his I:C ratios and it finally dawned on me that he must be out of honeymoon.
     
  5. momof2marchboys

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    we had went thru a very strong honeymoon - March-Sept with no insulin needs at all! We were very strict with snacks and drinks and watched everything he ate to keep him with in 40-80 carbs per meal as he had a 1:100 or 1:150 carb ratio for meals during that time.
    Then in Sept he had a very bad respitory infection and was put on a steroid and back on insulin we went. He uses very little right now, maybe 1 unit at each meal and very little during the day for basal.
    But we are noticing higher BG numbers during the nights (250-400) so we are adjusting his basal a little at a time.
     
  6. selketine

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    After diagnosis, my son only needed insulin during the daytime (he was on NPH and diluted homolog). I don't recommend NPH by the way - horrible time with it! He did not need any insulin overnight - pretty much went to bed and woke up with great numbers.

    After maybe 6-8 weeks or so his numbers started creeping up overnight - slowly. We started giving a bit of NPH at night - then switched over to lantus so he had a 24 hour basal insulin. For us it would the creeping higher numbers - there was no "low" period and then a dramatic change. I think he was completely out of the honeymoon in 4-5 months.

    His numbers were better when we were able to get off the NPH and go to lantus. Pumping was the best though - he started pumping 6 months after diagnosis. If it was up to me alone - I would have started him 1 month after diagnosis - NPH was a nightmare - and diluted insulin wasn't much better because he was so sensitive.
     
  7. Caldercup

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    Just like diabetes itself, I think you'll find everyone's experience varies.

    In our case, my son's honeymoon lasted almost three years. This past spring, we noticed a sudden jump in insulin needs, with near-constant increases in basal rates. Our endocrine team did the calculation and told us he was definitely ending his honeymoon. (Does someone have that calculation on hand?)

    This past month, our son's basals made another jump, so I'd say he's definitely out of the honeymoon now.

    Once we got the basals properly adjusted after initial diagnosis, I found the honeymoon to be quite helpful. Although he had some lows (and he was very hypo-aware), he never really had massive or long-term highs. We're dealing with them now and they are difficult to manage some days.
     
  8. 3kidlets

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    Hana had a pretty good honeymoon. She was dx right before she turned 9. From March to August she honeymooned and needed minimal insulin. Can't remember how much insulin she had but mainly the Lantus was enough to keep her stable. She would get 1/2 unit of novolog with meals.
    In August we were on vacation and she got a nasty swimmer's ear. I don't know if it was coincidence or what but that was the end of the honeymoon. Her numbers started going in to the 300s and she needed more novolog at meals. I had to increase the Lantus.
    I dreaded the day the honeymoon ended. That summer was nice because she went to girl scout camp and didn't need to worry about taking insulin with her meals - it was hot and she was running around and swimming. We had no problem with her numbers pretty much staying in range without insulin with her meals.
    But this is our new normal and it is good.
     
  9. Sarah Maddie's Mom

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    I can't really remember a sudden change in her needs those first few years. I do remember that even years into D she had crazy non-D days where she hardly needed any insulin at all. I also felt that after 5 years it just got so much harder to keep her in range. I suppose it is possible that her honeymoon lasted, to at least some small extent, that long, though I certainly didn't think at the time that she was still honeymooning.
     
  10. shannong

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    I read somewhere that if a child is getting between .5 to 1 unit/per kg of body weight they are probably out of the honeymoon phase. My son went the first 2 months waking up in range, no matter how high his number was at bedtime. Gradually he needed more and more basal. Managing nighttime numbers is crazy right now. How I miss the honeymoon phase!
     
  11. steph

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    My baby was Dxed in Dec. In April she had to start basal up again after being on it for just a few days right after Dx. In Sept she got her first virus and insulin needs more than doubled within the next month. During honeymoon we fought lows all the time. Now we fight highs more often and she rarely goes low. I don't really know which is easier or better, and there's really not much you can do about it either way. Just try to manage numbers the best you can. Honeymoons will end at some point, and then you have to learn all over again how your child's body responds to insulin. But it's not necesarily better or worse than the honeymoon (at least for us) just different.
     
  12. obtainedmist

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    According to our endo, Molly is still honeymooning 2 1/2 years after dx...which is sort of amazing since she was REALLY sick and had lost 32 lbs. (she was out of the country for 5 months on a high school exchange to Italy.) We were sure her immune system had killed off all of her beta cells! She's always needed basal, but her A1c's have been low enough so that the endo thinks she's still making some of her own.
     
  13. Debdebdebby13

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    Molly had a strong honeymoon, but she never went through a phase where she needed no insulin. Back the first couple of months after diagnosis she needed less than 3u/day total, including Levemir. Things increased a little, but at the beginning of June her needs doubled to around 8-9 units/day. Over the last 6 months her needs have slowly but surely inched up, mostly her basal, her bolus was 1:30 at diagnosis, went up to 1:60 during her honeymoon and then now it's back to 1:30 or 1:27 depending on the time of day.

    Now her TDD is around 15u/day, give or take. Some times she's gotten as many as 27u in a day, or as little as 10. D is crazy.
     
  14. buggle

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    My son had a pattern like that for over 3 years. His C-peptide was high the whole time. Even though he's in puberty now and is usually way above the honeymoon TDD/wt ratios and he's used as much 55 units a day, he still goes down under 20 units at times. He was still producing C-peptide last endo visit about a month ago. It does make life challenging. Thank goodness for CGMs and pumps -- though he keeps insisting on going back to MDI which is difficult when a kid has this pattern. He's been on the pump more than off lately. We've had to suspend for up to 4 hours a night this week and his TDD dropped in half again. His endo calls it a remitting/relapsing form for T1.
     
  15. maciasfamily

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    We're 10 months in and still honeymooning. Our son's needs are very low, and on diluted insulin. Most nights his pump is shut off with no insulin because he wakes low on his own. Before pumping, he wasn't on any Lantus, and very little humalog.

    Our dr told us for most people, the end of honeymoon is gradual and you'll slowly notice the increase of insulin.

    We also don't limit our son to certain carbs. He can eat what he wants (within reason) and how much of it he wants.

    I'm actually glad he's honeymooning, and do kind of dread the end of it since I know it will be harder to keep control of his BG, or it won't be as easy as it is now.
     
  16. dshull

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    Thanks for your replies. I think what I have to accept is that everyone is different and we have no idea how long this honeymoon will last! I just wish we could drag it out somehow so that if someday there is a cure he still has some functionality. Not that I am holding out hope for a cure. Thanks!
     
  17. MomofSweetOne

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    Does your endo routinely check c-peptide? I would love to know how much my daughter has. Last spring I accidentally turned her basal completely off and it was 12+ hours before the CGM alarmed a 200. The past few nights she's been dropping and then flatlining around 80. When I give her carbs, she goes and and then drops back to 80 and flatlines again. I've dropped basal doses, and she's still doing it. To me, it looks like her own betas are doing it because she shouldn't be dropping again when the CGM has shown a flatline for 2 hours, and she doesn't go below the 70s. Today she's used about 25 units of insulin. Within the month, she used 65 one day.
     

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