Honeymoon? Novice Questions

[Rhys.]

Hey all,

Nearly 3 months diagnosed in a few weeks time and what a ride it's been! I am still struggling getting hold of doctors to call me, although my nurses have been calling me every week, but I do understand there are more important things going on in the world. Was hoping some of you alot more experienced than I am, could help me understand this " Honeymoon " stage.

Everyday, between 12.00pm and 6.30pm, I notice quite steep drops, which is also backed up now, by my Libre sensor. I did suspect this prior to having this sensor, but it's now confirmed it for me. No matter what I eat, whether it's 100g Carbs or 200g Carbs after lunch, my blood glucose will not go anywhere above 8-9 mmo/L and is gradually brought back down to within 5 - 7 mmo/L within an hour ( Without no Novarapid ). This confuses me, because if I eat even around 30 - 40g carb breakfast in the morning around 9.00am, I will shoot to around 11 - 13 mmo/L ( Without Novarapid ). But afternoon to early evening, no matter how much I eat, they refuse to go any higher and do start dropping like someone who you would assume didn't have type 1 diabetes. Evening meals are different, as they do go as high as 12 - 13 mmo/L, depending on the meal.

Before being diagnosed, Naturally I would skip breakfast and eat " Brunch " I guess, at around 1.00pm everyday. My Body has been this way, for a good 10 years. I think my body naturally kickstarted insulin between the 12.00pm and 6.30pm time frames, prior to being diagnosed. Is there a connection to what my body previously went through regularly and the remaining beta cells I may have today? Could the remaining cells be working on a previous pattern my body was used to? Should I still be taking Novarapid for these meals to give them the breathing space they need? Or is my way of understanding this completely wrong?

I am still taking 10 units of Levemir in the morning and 10 Units at night. It's just I believe Levemir didn't work in this way, as it was slow releasing and not fast acting? My bloods seem to drop after mid day, as if I have taken 10+ units of novarapid, when in fact, I haven't taken any for nearly 2 weeks now. I don't get hypo's, as I frequently eat little and often too, but I am prone to getting them, atleast 3 - 4 times a day. My Average Blood Glucose is 7.2% without taking ANY novarapid for 2 weeks.

If someone could enlighten me on this " Honeymoon " period people keep telling me about and help with some of the questions, I'd be very grateful. Currently considering going private for a 1 to 1 session with a Doctor, as I won't be seen by NHS until November sadly. Noones fault, but Covid 19 though!

Thanks all
Rhys

 

[jackois]

Hi Rhys,

the 'honeymoon' period encountered by new type1 diabetics was explained to me by the consultant when I was diagnosed as a period where the pancreas, now getting help from injected insulin starts to make insulin again at varying rates until it finally gives up the ghost. This length of time varies from patient to patient.

A lot of us find that our metabolism affects insulin dosage, in my case I'm the opposite to you, in that I can take breakfast without insulin depending on what I have planned for the day, but tend to need higher amounts with my evening meal. This may be down to my long acting insulin being Novo rapid which doesn't manage a full 24 hours.

As it stands I think you need to eat to your readings. It maybe worth broaching a reduction in your daytime Levemir, but I'd suggest you talk to your nurse in the first instance.

Until you get more info from a professional you might like to have a look here, https://www.bertieonline.org.uk/ which is an online diabetic education programme which I found very good when I started.

Hope this helps, Peter.

 

[ert]

Wow, you're doing really well. I'm more insulin resistant in the morning as you are. Well, for me, it's actually the first meal when I break my fast, that I need the most insulin units/CHO. A lot of people have different carb ratios for breakfast, lunch and dinner as their IR changes of the course of the day. Most people can clear a certain number of grams of carbs with their background insulin - it's different for everyone, and that could be what's happening at lunchtime for you, coupled with it being when you're the least IR.
Not getting hypos could be sign you're still getting a glucagon response from your liver when your blood sugars are too low (which happens in normal people.) This eventually stops in type 1's. If it's not, then you're great at following the numbers.
It's certainly worth a discussion with your diabetes nurse and consultant.

 

[Rhys.]

Thank you Peter. I do believe that I will need to adjust my eating possibly, to when my body is performing best at the moment. I'm just finding it all very strange and no matter what video I watch, even the best of explained videos, there isn't one for " my " scenario at the moment. I have been recording alot of eating and data the past few weeks, so hopefully when I see a doctor, they can give me their opinion on it all. Just frustrating having all these questions, yet everything is massively delayed.

Thank you Ert. Very interesting when you mention about the Glycogen, as the other night, I apparently had 3 hypo's in my sleep, in which all 3 of them, were brought back up to 4.5 - 5 mmo/L naturally, with each one happening between 40 minutes and 50 minutes of each other. This happened between 3.30am and 5.00am. Bizarre reading. Unless I am misunderstood with the Glycogen action or have a faulty Libre, that could explain that to me.

Overall, I am not sure that the honeymoon period is easy to understand if it is the case. But I am trying to document as much as possible. Thanks again.

 

[MarkMunday]

... Everyday, between 12.00pm and 6.30pm, I notice quite steep drops, ... I am still taking 10 units of Levemir in the morning and 10 Units at night. ...

Figuring out what the dose and timing should takes a while. When you have got your basal dosages right, you can switch the focus to bolusing the right amount to cover meals.

Most T1s use a basal/bolus insulin regimen to get stable control. Basal covers background insulin requiements and bolus covers meals. Too much overlap and blood glucose gets out of control. Sounds like you doctor may have put you on more basal to start with to partially cover meals. That is often done soon after diagnosis. It works well initially but it will have to be reviewed at some stage. I would have this discussion with the doctor and then go about testing basal.

Post edited by moderator to remove definite advice on insulin dosage.