Type 1 Diabetes Honeymoon

Submitted by Thiruvelan on Thu, 04/11/2013
Type 1 Diabetes Honeymoon

"Honeymoon" means the period just after the wedding when things are at their sweetest and slowly wanes in a few months. Similarly, for some people with diabetes, the honeymoon period is with better blood glucose control. And it is gradually declining in a few months once pancreatic beta cells destroyed. For others, it might not be relaxing and fun. Instead, it is hot and boredom.

In one study of 103 children under 12 years of age with type 1 diabetes, 71 had a honeymoon. Reference: Pediatric Diabetes 2006 Apr; 7(2):101-7.

What is the diabetes honeymoon phase?

The honeymoon phase is the resurgence of the pancreas from autoimmune destruction.

The honeymoon period among people with type 1 diabetes refers to the period shortly after a diabetes diagnosis. During this period, the pancreas starts producing a significant amount of insulin due to some recovery of pancreatic islet cells. It helps reduce insulin requirements and aid blood glucose control.

During this honeymoon period, your blood-glucose levels may improve to normal or near-normal level. It is only temporary and does not indicate diabetes is recovering, improving, or cured.

How to I know I am in the honeymoon period?

When you are in the honeymoon period, then your exogenous insulin requirement will drop drastically. Also, your blood sugar level suddenly starts maintaining within a tight range say 80 to 150 mg/dl (4.4 to 8.3 mmol/l).

How does the honeymoon phase develop?

When exogenous insulin lowers the blood sugars, your surviving beta cells wake up, and the Honeymoon Phase can begin.

You know after t1d diagnosis, there is some undestroyed pancreatic islet cell. After insulin treatment, there is a decrease in glucose toxicity of islet cells. It facilitates the recovery of pancreatic islet cells and the release of some insulin; this happens after several weeks to months of diagnosis.

How long will the honeymoon phase last?

The length of honeymoon phase depends on the combination of the severity of the auto-destructive process and how early you are diagnosed.

Once the glucose toxicity around the Islets weakens due to insulin treatment, the beta cells begin to release large puffs of endogenous insulin. While this lasts, a person with diabetes is in the Honeymoon Phase.

Honeymoon periods can extend from weeks to even years. There is no fixed length of time and broadly vary between individuals. If you are diagnosed extremely early with less destruction of beta cells, then your honeymoon period can extend longer.

How do I prolong honeymoon phase?

Diabetes honeymoon period can be prolonged indefinitely; the trick is to assist the pancreas and keep it in a state of inactivity at your best.

The problem is by the time T1D diagnosed, at least 80% of their beta cells have destroyed.

High blood sugar levels are thought to be toxic to these beta cells, so keep very tight control of your blood sugar levels, help stop burn out beta cells. To prolong the honeymoon phase, you can do the following:

  1. Keep your diet relatively low in carb, this help stop overtaxing your pancreas. If you consume fewer amounts of carbohydrate, then you require less insulin and less strain to the islet cells.
  2. Getting a little bit of exogenous insulin (at least 1 unit) even when the blood sugar numbers are perfect; this frees up the pancreas from working so hard and extend the honeymoon phase.  
  3. Go gluten-free; t1d individuals have an abnormal immune response to wheat proteins. Reference: BMJ Case Reports 2012 Jun 21; 2012 & Diabetes 2009 Aug; 58(8): 1789-1796. Thus it is advisable to go gluten-free in extending your honeymoon period.
  4. Eliminating dairy might help remove potential antigens that stimulate insulin and beta-cell antibody production.
  5. High vitamin D levels can extend the honeymoon phase. Reference: Archives of Pediatrics and Adolescent Medicine 2012; 166(7):601-607. You can get required vitamin D by exposing yourself to sunlight for at least 15 to 30 minutes per day, preferably morning sunlight.
  6. Health benefits attributed to omega 3 fats are amazing. Omega 3 supplementation believed to lower autoimmune diseases. Reference: BMJ 2006; 332:739.
  7. Also, you can take herbs, yoga, acupressure & reflexology to strengthen your pancreatic function. They would not cure type 1 diabetes but likely can extend the honeymoon.

Do I need to continue insulin, if my BS is within range? Yes, you need to continue at least one unit of exogenous insulin, this help to prolong your honeymoon period and help achieve perfect BS numbers.

Is it better to be out of the honeymoon period for easy insulin adjustments?

For some, the honeymoon is pretty stressful. Indeed, some of the most fearsome lows of your life struck early in your Honeymoon Phase.

Some newly diagnosed diabetes hates honeymoon period, because of upset over erotic insulin secretion that may end up with frequent hypoglycemic episodes. If you are one, then you prefer to take just a minimum of one unit insulin and try maintaining your BS on the higher end to avoid hypoglycemia.

What can I do after the honeymoon phase?

How do I know the end of honeymoon phase? When your blood sugar is less predictable, more erratic, never in a tight range, and sudden increase in the exogenous insulin requirement indicates the end of a honeymoon period.

The BS highs and lows are much more difficult to manage once the honeymoon ends.

When the pancreas stop working, then insulin requirements are much higher, and you are subject to higher highs & lows, and more erratic swings between them. However, the end of your honeymoon phase is inevitable.

Generally, after the honeymoon phase, your diabetes management skills need to improve. During the honeymoon period, most diabetic can handle extra carb without much effect on blood sugars. But after the end of the honeymoon phase, this is not possible. Thus, you must give more attention to your food intake, exercise, and insulin quantity & time of administration.