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Forum Name: Diabetes
Question: When the "honeymoon" is over...
|Aimee729 - Mon Apr 27, 2009 10:17 am|
My daughter (16) was diagnosed with Type 1 diabetes, and is said to be in the "honeymoon" phase. Before insulin, her fasting glucose was 117mg/dL, HbA1c=6.2% and her C-Peptide= 1.68. She is in the care of a Endocrinologist, who sees her every 2 weeks and has put her on 2 units of Levemir at bedtime. Her morning (fasting) glucose is running around 100-105 mg/dL and is anywhere from 75 to 111 mg/dL during the day. Her doctor is happy with her progress.
My question is: what will my daughter experience when the "honeymoon" is over? I expect higher glucose numbers. Correct? Is this how we will know??
|John Kenyon, CNA - Thu May 07, 2009 10:49 pm|
Hi there --
This is an excellent if difficult question. The whole definition of diabetes, based upon threshold glucose numbers, has changed a great deal over the past 15 years, the bar having been lowered several times. Also, there is a grey area, especially with patients who are diagnosed in their teens or 20s. Sometimes these remain relatively stable indefinitely. Right now your daughter is responding very well, but if the disease progresses as per usual, yes, the end of the "honeymoon" will be heralded by increased glucose numbers. This can be very gradual or it can be rather sudden, depending upon the ultimate form of the disease. If this turns out to be "brittle" diabetes the numbers could suddenly spike. If not, they could creep or even hover. The important thing is to continue, even in light of very good results to monitor.
I wish you and your daughter all the best. She's off to a good start, and the "honeymoon" can sometimes last. It's just good to be prepared for anything in terms of the next phase, if there is one. Sometimes there isn't. The doctor is being very prudent. I hope this is helpful to you and please do follow up with us here as needed, and keep us updated in any case.
|Dr. A. Rajput - Thu May 14, 2009 2:40 pm|
I assume she is in Honeymoon phase of Type 1 Diabetes during which time glycemic control is achieved with modest doses of insulin or rarely insulin may not be needed at all. Her doc has put her on minimal dose of insulin to give rest to her diminishing beta cells of pancreas. However, destruction of beta cells is an ongoing autoimmune process.
So when the honeymoon period is over (which is subjective ranging from few weeks to months) beta cell function is lost and insulin is needed for rest of the life.
Yes, glucose levels might rise, but you need to monitor them frequently as per your doctor's advice. Many Type ones are admitted in emergency with a condition called ketosis or ketoacidosis in which there is a presence of ketones in urine.
So you must especially monitor her glucose levels when is not well/ill. That time, insulin requirement might go up.
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