I was diagnosed in July of 2014 and my doctor told me that I was in my honeymoon stage and she was unsure how long it would last. I have seen a number of answers to this question online and I was wondering if any of you participated in studies or just were able to explain how your honeymoon stage went? Furthermore, is the transition to having no insulin difficult or something that I should be preparing for? Thank you in advance for your answers.
Everybody's experience is different. In my case, I was able to manage well without insulin for a little more than a year. Eventually I noticed that it was taking way more work with diet and exercise to keep reasonable numbers, and my A1C was creeping up despite all the hard work. So I chose to start insulin about 1.5 years after my diagnosis. (Although I'm rather certain I was having BG issues for 1-2 years prior to diagnosis, so my honeymoon was likely longer than that.) So in my experience, a LADA's transition is gradual. Just think of this as time to get used to the idea of the next step.
Things actually would have been easier had I started the insulin sooner. Insulin seems scary at first but becomes normal quickly. And it was better than exercising after every single meal and still having higher numbers.
No studies, so I can't help you with that.
I insisted on insulin shortly after diagnosis in order to help preserve what beta cell function I had left. It made the transition to insulin very easy. I got a solid two years of honeymoon after diagnosis and still have a nominal amount of beta cell activity that I feel keeps me level when I'm in my target range of 70-100.
Today's pen-needles are almost as thin as a human hair. Virtually painless, and there is nothing more effective in achieving tight control than insulin. It's nothing to be afraid of.
Honeymoon stage can be highly variable. It does not necessarily mean transitioning to no insulin for a while. It's very likely that it will just be decreased maybe even tiny insulin doses.
Typically honeymoon is month to a year after diagnosis but especially for those diagnosed in very late youth or as adults, it can be even longer.
My honeymoon was almost a year after diagnosis and lasted for a month but only for a few of the days I did not take insulin.
If your doc hinted that you are already in your honeymoon stage, it's very possible that you will see insulin doses going up rather than down.
I would second Christopher's thought that using insulin is the best way to preserve whatever beta cell function you still have. If you're lucky and maintain good control your beta cells can help out for years making diabetes much easier to manage. I was diagnosed 7+ years ago and for at least 5 of those years, everything was a little bit smoothed out.
As a cab driver in NYC said to me and my wife when we were first married - Better a short honeymoon and a long marriage than a long honeymoon and a short marriage. I would start insulin early and go for the long haul.
Good luck,
Maurie
I second what pretty much everyone else has said. I started on insulin right away, but saw very good sugars and A1C for almost 2 years with a low carb diet and exercise. however, the transition was really hard for me as I started to see my a1c creep up. I tried to work harder and harder with diet and exercise, but that just ultimately made me feel like i was failing. accepting that I needed to use more insulin as my pancreas was producing less and less was a difficult thing to work through. But increasing my insulin has resulted in much better numbers overall. Hope all these responses help!
It's definitely highly variable. I honeymooned for 13 years without any insulin, and am still on very small doses (6 total units daily) 8 months after starting insulin.
The only thing you can do is watch your numbers closely and adjust as things change. There really isn't any way to know if it will progress gradually, quickly or somewhere in between. Just be prepared for any eventuality and you'll be fine.
I started insulin immediately that I was diagnosed (I was pregnant). After pregnancy I refused to go off insulin. Stayed on it through a second pregnancy until now. I do still have some beta cell function still even now. I used low carb diet combined with basal bolus dosing. Going on 6 years now. I cannot get normal blood sugars without insulin. But on the other hand if I skip insulin (and avoid carbs) my blood sugar levels will still be less than 180.
My best advice to anyone regardless of diabetes type is get on insulin early and learn how to use it well. Study is use and become your own science experiment. Don’t settle for diabetic level blood sugars. Target normal blood sugars(80-120). aim as close to them as you can get (low carb is very helpful at least for me in minimizing insulin dose, and avoiding both highs and lows).
Hi Hanna: IMO, Christopher and Maurie are spot-on by saying go on insulin early, and maintain tight control, and maybe you can prolong the honeymoon for a long, long time (may years). If possible, use an insulin pump. Since I was diagnosed ~20 years ago, I didn't have the advantage of some of the excellent tools that we have today, so my honeymoon lasted about 1 year. The only thing difficult about the transition was figuring out how much insulin I actually needed.
Wow 13 years..was that after you were diagnosed as having diabetes or does that include time when you were beginning to having blood sugar issues (pre-diabetes)?
I was diagnosed 6 mo. ago, LADA with an A1c of 11.7 and looking back I figure that my honeymoon has lasted 4 years. I was only diagnosed because I changed jobs and had a blood test for insurance purposes. I went on insulin (basal Lantus) the week I was diagnosed. Other than the psychological part (needle phobe)getting on insulin has made me feel so much better though I have a ways to go to get back to normal. In a couple of weeks I’ll see the endo for the first time to discus MDI or getting on the pump. The most important thing I’ve learned is that everybody’s diabetes is different and successful treatment is 90% dependent on the patient. Good luck.
It was 13 years after being diagnosed with diabetes (misdiagnosed as T2, despite being very thin, with no family history or any risk factors for T2). Based on symptoms, I'm sure I was diabetic for at least a few months before diagnosis (and possibly quite a bit longer).
This was 31 years ago, but mine was really full blown by the time I was diagnosed. Was unconscious due to DKA and in a coma, BG was 1140. So I figure my beta cells were pretty shot at that point. My initial insulin requirements didn't evolve much over the next couple of years. But some people continue to produce some insulin over the next few months to couple of years, and it can be erratic. Some T1D's still continue to produce a little bit throughout their lives if some of their cells survived the autoimmune attack. Researchers suspect that might be why a lucky few T1D's have little to no complications even after 50+ years. Sounds like you're still producing quite a bit if you're still not on insulin. You'll get used to it - shots are creepy at first but they're essentially painless and they just become second nature. But I'd encourage you to transition to a pump over time - you will love the flexibility and you'll get used to having this thing attached to you all the time and won't want to go back to shots. Be prepared to also gain a few pounds once you start insulin, which is a common effect until you get stabilized, since insulin is a fat-storing hormone. Best wishes to you!
So you didn't use insulin right away?
Excuse my ignorance, but is the difference between LADA and Type 1 just the time it takes for the insulin levels to go to 0?
I started insulin right after diagnosis with the pens. It's amazing how quick the numbers normalized.
So I was generalizing honeymoon to anytime with insulin after diagnosis until there is no insulin left. Do you use it differently?
Thank you! I'm already on insulin (small doses) so hopefully that will make it easier!
Wow! That's impressive. How did you find out that you had diabetes in the first place if you don't mind me asking.
I'm glad insulin has been working for you. I am also on the low carb diet with occasional cheat meals. I notice a lot of difference in how easy/hard it is to control the sugar levels with carb intake.
I'm in the stage now where I'm trying to find a ratio of carbs to insulin but it seems to have a lot of factors involved. Sometimes the same meal will do completely different things, but from what I've read - that is common across the board.