Honeymoon ending?

Type 1 and LADA New to Type 1 Diabetes
1

How do you know when the honeymoon is ending? Is it sudden? Do your sugars just get slowly worse?

I’m between diagnoses at the moment ( :stuck_out_tongue: ), and my doc is not sure if I have Type 2 or am in the honeymoon period for Type 1. Every time my blood sugars get worse and I need to use insulin (I stopped using it shortly after being diagnosed and was able to control my sugars with a very changed diet) I fear that my honeymoon is ending. This ends up with me freaking out before every period, and now again after surgery. I’m trying to figure out if my current sugar levels are due to my recent surgery or if it could be the honeymoon ending.

P.S. I’m phoning my doctor tomorrow to discuss it with him.

2

You will find that if you have surgery, before a period, while taking some medications, or during an illness your sugar levels will not be normal. Mine are double what they are normally.

3

Period just started - all is explained.

4

Sugar is at 277 (15.4), after 30g of carbs - a meal I’ve eaten before with no problems. I’ve noticed higher postprandials for a couple of days, but this is the highest my sugar has gone since I was diagnosed. I’m panicking!!!

5

Megan –

Did your doc do any of the tests to differentiate between T1 and T2? Your profile says T2, which is why I ask.

What I’d say is that, in isolation, you can’t judge based on one number . . . I remember a few random 200s at various points once I started honeymoon (usually high stress/high anxiety), and I’m still in honeymoon. I have found that if I don’t get enough exercise for a few days, my 2 hour posts will creep up, but I’ll still be back down to baseline (87-92) within a few hours, sans insulin. You could also be sick, etc - or your meter could be screwy. (I remember in the first week after diagnosis, I did a finger stick and it came back 495; I immediately rechecked and it was somewhere closer to 200.) Meters are not infallible, so I’d make sure to double check any number that’s out of whack.

Of course, since I’m still definitely in honeymoon, I can’t speak to what happens when you leave honeymoon, but I’d see what happens after a few days.

Hope this helps . . .

– Dov

6

Hey Dov

My doc didn’t do the tests to differentiate. He told me at my last visit that he was “leaning towards” diagnosing me as a Type 2, although he initially diagnosed me as a Type 1.

I checked the sugar level twice. First was 15.4, next (after handwashing and using a different finger) was 13.9, so it was definitely that high.

A big part of me wonders if it isn’t the honeymoon ending. My postprandials now go up to 10 (with a unit of rapid insulin and metformin), and before I could handle the same meal with my body’s own insulin. Yesterday’s 15 happened after a meal I’ve eaten many times before, and with a unit of rapid insulin. It seems as though my sugars are deteriorating, although I don’t know why. I lost a ton of weight, I’m sticking to the same diet and exercise routine, so I’ve changed nothing but my body has changed itself!

7

Megan –

If it’s T2, there is no honeymoon to end. Honeymoon only happens in T1.

PPs of 10 (which I believe is 180 on the US scale) aren’t terrible - either as 1 hour or 2 hour post-prandials. For a T2, that would put you in the “pre-diabetic” range. (They’re not ideal, of course, but if we could maintain ideal, we wouldn’t be on this website!) If, however, your meds aren’t covering you sufficiently, then you need to talk to your doctor - either this guy, or, preferably,a good endocrinologist. Have him run the autoantibody tests for diabetes - GAD, anti-islet cells, etc. That would firm up the diagnosis.

How were your post-prandials today? What are your fasting sugars like?

– Dov

8

Ah, so I’m panicking for nothing? I’d like to say that’s unusual for me, but, well, the shoe fits…

A couple of months ago I wasn’t having PPs of 10 though. I was having near perfect sugars with just controlling my diet (and yes, I’m a perfectionist, a trait which clearly isn’t helping matters). My PPs today were:
Breakfast - 8.0 (1 unit of rapid insulin)
Lunch - 7.1 (no insulin, but I walked home and back during lunch hour)
Supper - 10.9 (Two units of rapid insulin, but I indulged in a Caramello Bear as a treat - 2nd time I’ve done that since being diagnosed)
FBG - 5.8

The last time I tried to eat a “regular” type meal (well, the kind I would have eaten before I was diagnosed without problems) I ended up with sugars of 18 despite the 4 units of insulin I took. My body clearly can’t handle what it once used to.

I’m getting the contact details of a good endo. Hopefully I’ll get to see him soon and get some clarity.

9

I’m converting to US numbers, because we Americans are backwards and can’t use the same system as everyone else (what, you mean that 100 KPH isn’t the same as 100 MPH??) - multiply by 18, apparently. So your 2 hour PP for breakfast was 144, your 2 hour PP for lunch was 128, and your 2 hour PP for dinner was 196, with an extra sugar load . . . that ain’t so bad, except for the 2 hour for dinner, and that’s STILL in the pre-diabetic range.

For T2 diagnosis, 2 hour PP has to be above 200 (11.1); 140-200 (7.8-11.1) is pre-diabetes (impaired glucose tolerance); fasting has to be above 126 (7.0); pre-diabetes is 100-126. (5.6-7.0) (impaired fasting glucose).

Fasting is about 104, which, again, is pre-diabetic. Are you taking a basal insulin?

The other question is whether your exercise patterns have changed. I know that I can get my 2 hour post down to 81 (4.5) with even 15 minutes of relatively vigorous exercise (elliptical machine or treadmill), at least in the afternoons. In the AM, it doesn’t matter what I do or what I eat; I run in the 110s-130s 2 hour post - I think I have to tweak when I give myself my 2U of Lantus.

So, my best advice is see an endo - if you were up in these parts, I’d give you the name of mine, who’s excellent, but seeing as how you’re down in South Africa, that really won’t help you all that much.

Of course, I ain’t a doctor, just a not-yet-admitted-to-practice lawyer, but I’ve been talked off the proverbial ledge many times when it comes to a bad reading or 2 - and every time I think the honeymoon is over, it kicks right back in strong.

Hope I’m being helpful, and not giving you info you already have . . . we lawyers tend to do that sort of thing :slight_smile:

– Dov

10

Yes, I was really happy with yesterday’s numbers. Taking the rapid insulin when I think I need it clearly works for me. I forgot to tell you that I’m also taking 500mg metformin once a day.

I’m not on a basal insulin. My theory is that my body provides a certain amount of insulin which is enough to cover my basal needs, but not enough to deal with post prandials. I take a little bit of rapid to cover the meals, and I’m VERY responsive to it - 1 unit needed for every 30 grams of carbs (depending on the GI of the carbs though, intermediate or high GI carbs require more to cover), and that single unit is the difference between a PP of 10 (180) and a PP of 8 (144).

My exercise patterns haven’t changed, so it’s not that.

In terms of diagnosis, I think the mistake you’re making is comparing my numbers while I’m on a controlled diet, meds and insulin with the numbers of people who aren’t doing those things. When I don’t do the diet, meds and insulin, my numbers are VERY different. After trying to control it with diet for a few months, I decided to go back on meds when my fasting BG was over 7 (126) for three days in a row. Also, I felt like hell. AFAIK, you’re diagnosed as diabetic after a BG of over 11 (198) at any time or a fasting BG of over 7 (126) at least three times, so I’ve satisfied those criteria.

I’m glad I’m not the only person who overreacts to the numbers. I think the panic brought on by a bad number is compounded by the mood swings those number cause.

Thanks for the chat and the problem-shooting. It’s nice to find someone to talk to about it!

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My pleasure, ma’am - always glad to help!