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Pinch me! No insulin needed except Lantus

Discussion in 'Parents of Children with Type 1' started by forHisglory, Jan 31, 2015.

  1. forHisglory

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    I know it won't last forever, but our on-call endo confirmed it tonight. Our son does not need ANY insulin for carbs. Only 1 unit of Lantus at night as usual and only because we have the pen and cannot drop to 1/2 unit. What? I'm in shock. His values have been dropping and then stabilized at pretty much the same value for 24 hours. We haven't needed to do any corrections for 72 hours. Food doesn't really change it. I thought we would be in for a nightmare as he is just getting over a stomach bug.

    So, why give the Lantus? Endo said research shows it will prolong the honeymoon. He believes the pancreas is working big time.

    I want to be excited, but I know its only temporary. Why can't they figure out something to "freeze" this honeymoon for type 1 diabetes? Why must we just wait like sitting ducks waiting for it to return? This is the biggest "gotcha" ever.

    Mixed emotions here. :cwds:
     
  2. sszyszkiewicz

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    Just thank God for those days. Hopefully it will last a long time!
     
  3. forHisglory

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    I am thanking Him big time. It is a relief......but it makes me sad. My boy is acting like he used to (despite recovering from the stomach virus), full of energy, and its like this nightmare never happened. He hates getting the injections but started getting used to it. I've already been grieving it and the endo says, " keep checking glucose as normal, things could change with the next cold."

    I feel tremendous pressure to keep his stress, illnesses, diet, etc. perfect so I don't shorten the phase.......its like the big scary monster lurking under your bed.

    But thank goodness. I will take a partial remission!!
     
  4. jenm999

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    I'm happy for your son and I hope it lasts. I wonder if you can get him into any studies? There's got to be something to learn from him and his unique physiology that is making this possible. Our control in the first few weeks was outstanding but he never experienced this decline in insulin needs.
     
  5. forHisglory

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    Thank you, I am completely surprised. I have been looking for studies. I can't find any for his age (6 years old). There is one available for children age 12 or older. If anyone comes across something, please let me know!

    I found this article on PubMed that was done in August 2014. It is fascinating and partial remission (PR, aka honeymoon) can last up to 551 days if A1C's are kept low and chances are better if the child is male, over 5 years old, not in DKA upon initial diagnosis, and has a low A1C in the first three months of treatment. Here' s the article in case anyone else is interested. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164125/
     
  6. mwstock

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    I have heard that the honeymoon period can be extended months and possibly year(s). My son was diagnosed at four years old. He is now almost ten years old. One part of coping with a child with type 1 diabetes is not only physically managing the blood sugars, but also managing the fear and stress which accompanies the diagnosis. It takes a while to process the emotions that come along with the diagnosis. It is a grieving process, grieving the life before type 1. There are days where the burden can be very heavy, but there are also those days which are lighter and we do really good with the challenge.
     
  7. jenm999

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    My son meets all those criteria, and our honeymoon is ending now at 10 months post Dx. :(
     
  8. momof1CWDinohio

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    We had something similar happen to DS about 3 months after he was diagnosed. It was July 2010; he was 6 and had just finished kindergarten after being diagnosed in April. We struggled with many many lows for several days before stopping Humalog and just having 1 unit of Lantus per day. Sadly, this lasted only about a week before his needs changed again, and he needed to go back on the Humalog. I hope your mega-honeymoon lasts longer!
     
  9. Christopher

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    I hope you take this in the spirit intended but I would not consider this a "remission". I think you are setting yourself up for disappointment once his honeymoon is over. The sooner you accept that this is not going away, I think the better it is for you and your son. It is great that his bg is in range right now, but don't look at it as "waiting like sitting ducks". If you haven't already, you could take this time to read some books on managing Type 1 diabetes, learning about counting carbs, weighing and measuring foods and drinks, etc.

    You said yourself you feel this huge amount of stress to keep everything "perfect" so you prolong his HM period. Is that really how you want to live? Don't you have enough stress in your life? A lot of managing this disease is how you approach it in your mind. Meaning there is an aspect of mental toughness in order to not give in to all the negative things that are in your mind on a daily basis. I think we all struggle with this and, at least for me, it was worse in the begining. I am just saying these things to give you something to think about and hopefully make your life better.
     
    Last edited: Feb 2, 2015
  10. susanlindstrom16

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    I just wanted to throw out there that stomach bugs have huge impacts on how the body absorbs carbs and the effect could last a while, like a week or so. I don't know when your son got over it. The first time my daughter had a bug after diagnosis we had at least a week where the smallest amounts of humalog were sending her low. We even went to a birthday party and didn't have to bolus for pizza and cake! This was extremely unusual for us because she did not have a honeymoon at all, at least as far as I can tell. So i'm no expert on the honeymoon stuff, but thats our stomach bug experience.

    I couldn't stop myself from thinking during that time that her being ill had somehow "cured" the diabetes- I think its just human nature to have thoughts like that. Hugs to you on dealing with this emotional roller coaster, and congrats on making it through your first sick day!
     
  11. Snowflake

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    Congratulations! I think as long as you take this as a temporary reprieve, you should enjoy this as a time to get used to the diagnosis and learn as much as you can about Type 1. Our daughter really didn't honeymoon at all, to the great surprise of her endo because she was dx-ed after only a few weeks of displaying symptoms and not in DKA. Within about 10 days of diagnosis, we experienced both her first post-diagnosis 400 and 40.

    A year or so back, there were some interesting posts on the website A Sweet Life from a mother trying to extend her 6-yr-old daughter's honeymoon. Even though the information didn't apply to us, I found it interesting to follow her journey. I can't vouch for all the research and case studies she cites, and the child's honeymoon did ultimately conclude, but it makes for some interesting reading. I can't find all of her posts as a package, but here are a few, including the one she wrote after the honeymoon ended, and you can navigate around the website to find others:

    http://asweetlife.org/feature/how-long-can-a-diabetes-honeymoon-last/

    http://asweetlife.org/katieb/blogs/children-blogs/the-diabetes-honeymoon-is-officially-over/37110/
     
  12. Sarah Maddie's Mom

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    During the first 5 years post dx we would have the occasional "no diabetes" day or two when she could eat without injections.

    I think people mistakenly think of the "honeymoon" ending like an on/off switch when it really isn't.
     
  13. MomofSweetOne

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    I agree with this. We used to see times where the CGM would alarm at 80 at night. I'd give juice, later look to see a small spike and then a return to 80. No lower, or just enough to trigger the CGM alarm, but not a continued descent, so we (and our team) believed those nights were her own pancreas helping out. We haven't seen that for about a year now, and the last few months have been very challenging differently than the puberty craziness was. Foods that used to be free and just give a nice straight line like cheese & chicken now require insulin or she ends up in the mid 200-300 range 3+ hours later. It's been another stage of grief, especially for my daughter, as those were her go-tos when she didn't feel like thinking about dosing.

    My daughter never went completely off insulin during her honeymoon, though she did go off daytime insulin for a bit (and we tested more than when giving insulin!). Looking back, I'm thankful she didn't. I think the grief of her needing to go back on would have been harder than dx already was.
     
  14. forHisglory

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    Dad to Danielle. I would take some time to read some books yourself. Partial remission is a term used in medical literature to describe the "honeymoon phase." As for all the rest of the ED, I have my doctorate and have been practicing medicine in a related field for 7 years. Despite my medical knowledge, I still find myself dealing with this in an entire new way. As a mom and not a doctor. The endo nurse herself was surprised to learn that the LIVER also produces sugar. So with that said, I will definitely take this partial remission wholeheartedly and it looks like we are headed to a full REMISSION. It is rare but it does happen. I am rejoicing and praising God for his great work to give us some grace here. The full blown disease will return. For now, I've tossed my meticulous carb counting of the past 4 weeks (docs suggestion!). To hell with diabetes. I'm thankful for this last bit of normal life we are ever going to see. For the encouragers here, thank you so much and I will keep you posted!!
     
  15. Sarah Maddie's Mom

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    No reason to be so rude.

    Good luck with that "remission"
     
  16. DavidN

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    Please keep us posted if the T1D doesn't come back. I'll give Him his glory when he puts one score on the board.
     
  17. sszyszkiewicz

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    Every day with good numbers is a win,no matter how you get there.
     
  18. DavidN

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    100% agree.
     
  19. wilf

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    I'm not sure from what you've posted if this is remission/honeymoon, or just the after effects of a stomach bug. DD had several over the past 8 years, and insulin needs would drop to just needing basal. It would last for up to week, and then things would return to where she'd been at before the stomach bug.

    Either way, it's nice to get a break - whether it's for a week or a longer period. Take it and as other posters have suggested take the time to really learn about best practices for managing your child's diabetes. Have you got Using Insulin by John Walsh? If not, go get and read it now while you have some downtime. Don't assume that just because you're in the medical field that you know all about D management. It is a highly specialized set of knowledge and skills. Your goal should be to know more about how best to manage your child's diabetes than your endo. And you're not there right now.

    I'm also concerned about the cheerleading/mourning attitude which is coming through in your posts. This is a marathon, not a sprint. Your child is going to pick up on your ecstasy/anguish vibes, and it may create problems down the road. You are a medical professional. Try taking that sort dispassionate and scientific approach to this. It will serve your family better in the long run.

    Good luck! :cwds:
     
  20. forHisglory

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    I should add the stomach bug only lasted 12 hours. He was already down to practically no insulin for carbs for a week prior. Thankfully he is extremely sensitive to insulin. His endo(s) expected us to go to almost nothing at some point. I'm thrilled we are there! And I will mourn when it becomes more difficult again. I do really appreciate the positive and helpful replies here.
     

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