Define honeymoon

One year ago 8.5. With meds 5.7 in 6 months. Now rising. 6 1 to 6.4. But diet better and better. Was there a honeymoon here.

Last 6 weeks 110 or less two hrs after eating so I hope the A1c going down.

The “honeymoon” is something that happens in Type 1 diabetes. It’s the period following diagnosis when the pancreas recovers a bit and is able to produce some amount of insulin. Blood sugar control is generally more stable with lower insulin doses. Eventually, after weeks to years, the honeymoon ends and people find that control (often) becomes harder and they require more insulin.

I’ve never heard “honeymoon” used to describe Type 2 diabetes.

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I would add it is something that happens after insulin therapy is conmenced-- not just after diagnosis… in which the natural insulin producing ability is jump started again by the exogenous insulin. IMO it can’t happen with any other medications.

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Yep, I agree. I know some people with LADA describe the period between diagnosis and starting insulin as their honeymoon period, but I think this is an incorrect use of the term.

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Well I think sometimes in LADA an initial bombardment of insulin therapy may be enough to sometimes jump start insulin production to the point that some people can go off insulin for some period of time-- and in that sense they might be kind of right---- but the only way a honeymoon starts is with insulin therapy.

You’re right there have been many instances lately of the concept being misunderstood on the forum IMO

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I actually use it to describe the period between using basal insulin and oral meds and using insulin for everything.

Honeymoon is a perspective. I remembrance of times that were better and easier. I doubt that honeymoon is something that you can recognize and necessarily enjoy while it is happening. It is hard enough having diabetes. But later, only when the going get’s tough do you appreciate how easy it was in the begining.

Not everyone looks back on the honeymoon period with nostalgia. For my daughter, it was a turbulent time with unpredictability that surpassed that which she is experiencing during puberty. There was just no way of knowing when her bruised and battled remaining beta cells would gather together and throw out some endogenous insulin (how much this time?) in a feeble attempt to control her BG. This significant unpredictability really mucked up our attempts to stabilize her BG, as I’m sure you can imagine. We were both quite relieved when her honeymoon ended because her T1D became more predictably unpredictable, if that makes any sense.

This is where I believe (and take this with a very large helping of YDMV) “juvenile onset” Type 1 differs from LADA. In general, the honeymoon in LADA is much smoother, and involves significantly fewer “fits” and “bursts” of endogenous insulin production (kind of like a faucet that is left open enough to allow the water to trickle out in a fairly consistent manner) when compared to “regular” T1D. I use this simplified analogy: LADA is like falling off a cliff in slow motion. You just slowly drift down until you touch ground of the land of (essentially) no more endogenous insulin production. “Early age onset” Type 1 is more like falling off the same cliff at a much faster (but not consistent) velocity and hitting the ground below HARD. Except you have to climb the mountain repeatedly and fall off the cliff over and over again until you are finally “allowed” to stay on the ground in the land of (essentially) no more endogenous insulin production. The act of falling off that cliff repeatedly and with absolutely no rhyme or reason was a major PITA, and managing my daughter’s Type 1 became easier once her honeymoon was over. It was as if her Type 1 began making at least a feeble attempt to more closely follow the “Type 1 Rulebook”.

I don’t disagree, perhaps the same applies to some people with their marriage? Or maybe not.

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Unfortunately, unlike an unemployed (by choice) husband who won’t bother to learn the first thing about his child’s D and therefore assist his overworked wife in the management of said D, one cannot divorce D… (Or: The “cure” for a bad marriage has already been discovered. :wink:)

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I read somewhere that it is technically defined as using less than .5 units of insulin/kg for your TDD. Seems arbitrary, but I guess doctors need something to put in their papers to define honeymoon. By that metric, my son was never actually honeymooning, although it’s clear to me that he did have some random bits of endogenous insulin production at the beginning. Feel like that is pretty much gone now.

This is also my understanding about the “official” definition of the honeymoon period.

In communicating with other parents of children with T1D, I have heard about a wide range of “honeymoon” experiences, anything from none at all to over two years. Don’t quote me on this, as my observation is based on a relatively small “N”, but I seemed to detect what might be an inverse correlation between A1c (or “severity” at initial diagnosis) and length of honeymoon. As an example, my daughter was diagnosed when her non-fasting BG was in the 300s and she had had few symptoms (increased thirst and more frequent urination) for only 2 days or so. However, her A1c at dx was 12.something. If memory serves, her honeymoon lasted around 18 months or so. Another parent I know: Her daughter was not diagnosed/treated until she nearly died in DKA. She had virtually no honeymoon. This “rule of thumb” does not always seem to be reliable, however. It does stand to reason (somewhat) in that the “sicker” one is at diagnosis, the fewer viable beta cells remain that can “recover” once exogenous insulin is started and rally in their last-ditch effort to keep BGs in range.

In our case I think that rule doesn’t seem to hold. He was diagnosed with an A1C of 7.2 after one day of increased thirst and urination. He didn’t have any remission and those that initially seemed to be a honeymoon were actually stomach bugs :frowning:. But his antibody levels were through the roof. His insulin antibody levels were 80 JDRF units, and I read somewhere that anything over 20 was considered high and predicted a very short or nonexistent honeymoon.

As a type 2 diabetic I experienced a different kind of honeymoon.
After successfully managing my blood sugars with diet and exercise and no meds for 16 years I had a cardiac arrest with resulting severe brain injury and ended up spending a couple of years in rehab, subject to (yuch) hospital food and mobility issues.
Prior to that I had kept my hba1c in the low 5.0s during the initial 16 years. After those 2 years of rehab and recovery from the brain injury my hba1c was still below 6, but after a few months started to rise, eventually passing the 7.0 mark at which point my doc prescribed metformin.
So for me my honeymoon was the two years after my cardiac arrest where my blood sugars were normal and until I reverted to being diabetic again…
.

Really sounds like we’re talking about a number of different things, but at least one point of clarification: LADA has that “L” thing–“Latent” in it that explains why people may not actually need insulin at first (and often get misdiagnosed T2):

But unlike type 1 diabetes, with LADA, you often won’t need insulin for several months up to years after you’ve been diagnosed." http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/expert-answers/lada-diabetes/faq-20057880

So that’s honeymoon-ish but it’s not restricted to LADA and I don’t think it’s what the term originally referred to. It’s been around for a long time and I believe was originally associated with “juvenile onset” from back when age was still thought of as a determinant for diagnosis. Even with acute-onset T1, whether in kids OR adults, there’s this phenomenon where the auto-immune response has not wiped out all your beta cells yet and you still have some endogenous insulin production. This is how it was explained to me back in 1983, which was kind of on the cusp of that “juvenile/mature” to “T1/T2” terminology change. Mine was sudden-acute, not LADA, even though I was 28 (my actual dx was “juvenile-type diabetes mellitus”–still on my record that way I recently discovered). The day I was dx’d and started on insulin the Dr told me to expect a “honeymoon period” because my cells would still be producing some insulin for a while, but eventually that would pass and I should expect my insulin requirement to go up. As @Sam19 suggests it may be related to a rebound effect due to the exogenous insulin alleviating the burden on your own betas, but it doesn’t refer to the slow-onset LADA phenomenon specifically.

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This topic was started in the Type 2 category. Lot of people believe that honeymoon is something that happens in T1, but some professionals believe it happens in T2. In particular, if you are diagnosed with T2 in a “bad way” and are put on insulin immediately. You may find that with changes in your diet, exercise and medication that you can at least partly put your diabetes in remission and stop insulin treatment. For the vast majority of those with T2 it is progressive so if you live long enough, you will probably end up back on insulin. But that time when you can stop insulin, I would argue that is a honeymoon. Sadly, my diabetes wasn’t amenable to this, my progression was not like this, I was denied insulin and by the time I started I was dependent on it.

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Yes–I didn’t mean to imply there was only one way to apply the term; rather the opposite: it refers to different things as applied to the LADA (slow-onset) phenomenon, the rapid-onset phenomenon, and as you point out, a T2 phenomenon as well.

My Ph.D. is in Old & Middle English so I’m a bit obsessed with etymology and language history. Doesn’t mean I want to see terms restricted to their “original” meanings but I do think it’s useful to know where they came from and how they’re evolving. My guess is that it started back in the day as a handy layperson’s term for a phenomenon observed in the treatment of “juvenile” diabetes, though it would take a historical literature search to pin that down. Maybe I should finally break down and get that $300 subscription to the online OED. The google machine turns up almost exclusively T1 references for “diabetes honeymoon” but it’s not much help in determining historical usage. In any case the term is clearly becoming more referentially diffuse on sites like this one, and I expect that will continue. Nothing wrong with that–people adapt language to their needs–but it does mean there can be some ambiguity as to what you’re referring to if you don’t provide sufficient context.

From everything I’ve heard before (completely reinforced by the discussion above), it really does sound as though “honeymoon” means different things to different people. Not that someone, somewhere, hasn’t codified a specific definition or definitions; notwithstanding, people seem to use the term very subjectively. What it means to Tom, Dick and Harry are often three different things.

oh no, i THOUROUGHLY enjoyed it when it was happening. i realised it was a massive gift and tried to keep it going as long as possible. i remember it fondly now. mine was predictable and allowed me to eat basically anything carby with 1 unit of novorapid and a bit of exercise afterwards. it was great for me.

that sounds pretty horrible.i was 36 at rx and my honeymoon was a dream. it should be like mine for everyone.