I was just wondering if anyone knows whether or not it is possible to go back into the honeymoon phase after being finished with it for quite some time. my 6 yr old boy was diagnosed with type 1 nearly 2 years ago, started honeymooning shortly thereafter as was completely finished honeymooning over a year ago (I believe he sarted leaving the honeymoon phase 6 months after diagnosis. at our appointment over a year ago they said he was finished that phase). But over the last few weeks he keeps going low and we keep having to cut back his insulin and we are still seeing lows. Most of the basal settings on his pump are at the lowest they have been since starting the pump in october and some of his insulin to carb ratios are back to where they were in the beginning of his diagnosis. I don’t know what to think, but it seems like either his body is making some insulin or his carbs are somehow not being absorbed into his system (though he has been going low at night too when there should not be any carbs left in his system and only basal insulin). Is it possible to have re-entered the honeymoon phase after so long? He also had 2 big growth spurts in December where we increased the insulin but now we are at less insulin then before either of them. Has anyone else seen this happen or have any idea as to what might be going on? Thanks.
Honeymooning is based on how much residual beta-cell mass is left. Once the beta-cells are gone, there should be no endogenous insulin secretion anymore. So I would doubt that it’s a 2nd honeymoon. If you want to know for sure have your doc test for c-peptide. If it’s there, then yes he has residual beta-cell function and an elongation of the honeymoon… if not then no it’s not an endogenous insulin thing.
More likely that his insulin sensitivity is just changing with the hormones. Have you checked for ketones?
Tracy, is your son more active than before? I’m not sure if you’re in a snow area, but where I am at we got a freak winter storm and seeing how I’m from Florida, wanted to go out and play in it and I ended up going super low due to the extra running around. Another thing is hormones affect the amount of insulin that one requires. If he’s recently, as you mentioned, gone through a growth spurt then his insulin needs will shoot up and then come back to normal-ish, this can be lower than before. One other point I’d like to mention is that pumping makes your body use insulin more effectively, therefore you’d end up using less as your body is being more efficient. And then there’s the issue of maybe the site is in a vein? Have you done a site change since the weird numbers?
I hope this helps you figure things out… then again, after my 20 years experience, there’s sometimes no answers for this disease!
PS- Lynne, you can have ketones even while running low or sick.
Almost three years since I was diagnosed T1. I didn’t have much of an initial honeymoon phase probably because of DKA burning out my beta cells. I occasionally have periods of consistent lows that can’t be related to increased activity, seasons, different food or anything. I question if our beta cells are completely kaput & every now & then send out a spurt of insulin. Know people who’ve had diabetes for a long time who experience the same. These episodes don’t last long for me. Perhaps this is more pronounced in a young, growing body.
i have not checked for ketones, i have only done so if he has been high or sick. how would he have ketones from being low and what would one do if he did?
If anything he has been less active as it has been so cold here (like -30/-40) that they keep having indoor recess at school and it is too cold to play outside after school. the one day it was nice and we went sliding he ended up being a little high (go figure), though tonight we went to gym night at the school so tonight he was active, but we were only 20 minutes in when he went low.
this has been going on for weeks, over numerous site changes.
i dont know if we had c-peptide, but i doubt it. what is involved in that (is it a blood test? the only things they check in his blood tests are a1c and thyroid).
This can happen. It happens to me. Sometimes I need more, then sometimes I need less insulin. It can be that he is more active at the moment. Diabetes is fickle and can do things to us for no known reason.
My suggestion would be to increase the carbs, giving him a slow release carb snack at bed time to try and see him through the night and perhaps some milk if he can take it. He needs his sleep bless him. So do you and neither of you will get this if you are both either suffering a hypo or worrying about one. It will go down eventually.
Yup. I’ve had D for 18 years and I still go through brief phases where it seems like my insulin needs are abnormally low for my activity level and food intake. And things seem easier to control. It’s just one of those frustrating aspects of the disease. Just when you think you have something figured out…bam! There’s some decent evidence out there that beta-cells can survive long after the autoimmune process would seem to have finished (a higher proportion of the joslin gold medalists than you’d think had beta cells post-mortem), but whether this or other metabolic changes are the reason for these phases is anyone’s guess.
Hi, i just wanted to poke my head in and say “hi”. I agree that the c-peptide test will help you and your doctor understand more of what is going on. In 1962 i was 4 and diagnosed with type 1. of course, there were no pumps, glucose meters, etc. but we still had the same “mysteries” that go on today. I talked to my parents about your issue and they remember going through such phases when i had “growing spurts” or other changes in my body. For some reason they say there were more lows than highs during these times. I feel that you’re checking your son’s glucose levels regularly so please keep that up and be sure to take a copy of the readout to the dr. with you. make notes regarding any activities, sickness, etc that may affect the readings. Please make sure your Endo knows what’s going on (you’re not a bother! it’s his duty to know his patients) and urge him to work closely with you. if it hasn’t already, Diabetic life wil become natural and normal for the whole family. Keep up the good work!!!