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Honeymoon Period Ending?

hale710

Well-Known Member
Messages
2,903
Location
Scotland
Type of diabetes
Type 1
Treatment type
Insulin
Hi all!

ive been diagnosed almost 3 months now, and been in the honeymoon period for 6 weeks. all was fine until a went on holiday last friday. 2 days into the holiday i found myself strugling to get into range. i put that down to the different food in the hotel and trying to enjoy myself, so i just said it'll be fine provided i keep under 10 mmol/l and that i would get myself back on track when i got home.

I've been home 5 - 6 days now and i just cant get back down. ive been using a 0.5 units per 10g carb ratio during the honeymoon period but it just doesnt seem to be cutting it anymore. do you think this could be the sign of the honeymoon period coming to an end? should i start increasing my ratio or speak to my DSN first?

I'll pop some BG readings here for a few days to see if anyone else can see a pattern!

Sunday
BFast - 6.9 ( I had been out the night before and had quite a lot to drink so this was a pleasant result) I did not eat
Lunch - 7.6, 80g so 4 units........... bingy kind of day :lol:
Dinner - 10.7, 35g carb so 1.5 units
Bed - 9.2.............. this wasnt particularly long after dinner so i knew i still had some novorapid working

Monday
BFast - 7.7, 44g carb so 2units
Lunch - 7.6, 40g so 2 units
Driving - 8.1
I am very aware that driving drops my BG and I then walked my dog for about 45 minutes
Dinner - 6.9, 60g so 3 units.......... i was pleased to finally be under 7
Bed - 7.9

Tuesday
BFast - 7.3, 35g carb so 1.5 units
3 hours later felt odd so tested - 14.4! so i took 2 units to correct
Lunch (1.5 hours after correction) - 11.4, 55g carb so 2.5 units
Driving - 6, had 5g carb snack to prevent going low while driving. no walk that day
Dinner (3.5 hours after driving) - 7.2, 40g so 2 units
Bed - 8.5!

Wednesday
BFast - 8.2, I had the same breakfast as yesterday so based on the big rise i gave myself 2units as opposed to yesterdays 1.5
Lunch - 10.3 :evil:

It just seems to be creeping up and up despite me doing a few corrections. I get up at 5.30am so my breakfast adn lunch are taken earlier than lots of other people. i take 3 units leveimer at 6pm every night and since there doesnt seem to be an substantial drops over night i think that this is an ok level. i havent done any testing overnight for a while but i might give it a go at the weekend to be doubly sure.

any bright sparks got an idea?
 
Could well be, I've read that the Honeymoon period can last only a matter of weeks, months or even years in some cases, you sound as if your well aware about carb counting so just adjust your insulin accordingly.
 
I think tomorrow ill adjust slightly and see. I find it hard to change sometimes as since my doses are so low, a "small" change can have quite an effect on me. I suspect I've got a few hypos coming my way as I adjust to the changes but fingers crossed for nothing too dramatic!
 
Holidays are always a challenge to get right though because of the climate change, drinking, routine, food etc; so I wouldn't pay attention to those readings if I were you.

That being said it does sound like you could be coming out of the honeymoon period. The key thing is to get your basal right, you'll end up chasing your tail trying to get your Novorapid AND Lantus right at the same time, so just concentrate on the basal to start off with. It's generally fine correcting between meals with Novorapid, but don't rely on it.

It's fair to say you can expect a wobbly period until you figure out your new doses.
 

I was kind of under the impression that my basal was correct though? Overnight I see very little change, under 1mmol/l. Ill do a fasting test again at the weekend to be sure

My DSN isn't keen on me correcting at all as I'm in the honeymoon period (or was....) and generally it sorted itself out, but readings of 14 I just couldn't ignore.

These readings are since I've been back, the holiday ones were consistently 9-11 despite my best efforts! Even after a couple drinks it didnt go below 8.5
 
Ah yes, sorry, I was just providing some generic advice. You're right, your overnight levels are consistent so your Lantus doesn't appear to need changing.

The doses of Novorapid that you are on are tiny and I'd expect them to increase once your pancreas finally packs in. Looking at Tuesday's and Wednesday's post-breakfast readings; on Tues you gave yourself a 2 unit correction dose, so perhaps on Wednesday you should have given yourself 3.5 units. Although, I'd exercise caution as you are clearly in a state of flux. So make sure it is a pattern. Back in the days when I saw a DSN she told me if it happens three times in a row then it's a pattern.
 
I got the basal sorted with a bit of help from think like a pancreas a month or so ago!

Yes my doses hardly seem worth it sometimes! The half unit pen has been a life saver, only 1 hypo since I got it.

I've also had a headache pretty consistently for 5 days now, I don't know if it's a cause, a symptom, or completely unrelated to the higher readings!

I think ill try and stick to the same breakfast and lunch the rest of this week and gradually increase the doses until I have a new ratio to work with. Would that work? Dinner isn't a great indicator as I often exercise before hand

I'm still debating whether I want to try low carbing. So far I've had no real need, but once the honeymoon is over I'm not sure how my body will react. I just love pasta though......
 
I think ill try and stick to the same breakfast and lunch the rest of this week and gradually increase the doses until I have a new ratio to work with. Would that work? Dinner isn't a great indicator as I often exercise before hand
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Sounds like a great idea, exactly what you need to do. Just to confuse things though, you may experience the Dawn Phenomenon now you're coming out of your honeymoon, so don't expect the ratios for breakfast and lunch to be the same. They might be - only one way to find out! Your lunch and dinner ratios should be broadly consistent.

And with low carbing, I'd only do it if you can't achieve good control with carbs. If I could do that, I'd definitely not be low carbing.
 
I already have dawn phenomenon a bit I think. I get a pretty rapid rise between waking and breakfast on the days I don't work. On the days I do I find that the stimulation involved in driving seems to keep it at bay. Weird! I can't stand eating when I first get up so I figure ill maybe have more issues with it later when things really get going!

I agree dinner is very different due to having a walk before, but even when I don't I find it easier to get lower in the evenings. Currently I can often go without insulin depending on what I had for dinner. I also have lunch as my main meal of the day which I've always found helps when maintaining a steady weight

Will give things a go and see what happens!
 
hale710 said:
My DSN isn't keen on me correcting at all as I'm in the honeymoon period (or was....) and generally it sorted itself out, but readings of 14 I just couldn't ignore.
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Very few if any DSN's will advise patients that they should correct between meals, reason being is the 'stacking effect' of multiple insulin injections.

As your no doubt aware Novorapid can take up to 4-5 hours before it's completely exhausted, therefore if you inject in-between meals then again when you eat there's a likelihood that you could hypo postprandial due to the first injection still being active, I've experienced it myself but don't often do correction between meals nowadays.

It's fair to say that the next few weeks is going to be challenging and demand a lot of your time, stick with it as things will eventually settle down and all this will be distant memory

Once things have stabilised get your name down for the DAFNE course, usually they insist that you must have had diabetes for at least 6 months, as the waiting times are long it might be a good idea to ask your DSN to put your name down now.
 
My name is down for DAFNE already. Unfortunately my career is at a standstill since diagnosis. My consultant has arranged for me to skip the waiting list as DAFNE is the one way he can really confirm I'm safe to travel offshore as then he can guarantee they've given me all the tools I need. Even then I'm not doing it until November as its not ideal being in the honeymoon period.

On the rare occasion I do correct between meals it's because I can physically feel the effects of the hyper, like at 14.4. I have seen my cousin when she ended up stacking once and it wasnt pretty!
 


Excellent news that they are pushing you ahead of the waiting list as you job depends on it :thumbup:

I keep saying to my DSN that there should be more DAFNE courses rolled out, it all boils down to funding and as budgets are getting more tightly squeezed I can't see it getting any better TBH, some members have reported that the waiting list is two years or more!

I know what your saying about hypers btw, at 14.4 I would feel pretty awful too
 
They run DAFNE 4 times a year up here. When you consider there's not many people per class it's really not enough!
 
I'm also booked on DAFNE in Nov. Quite lucky as only diagnosed recently. I have heard very good things about the course and my employers are allowing me a week off paid to attend !


Sent from the Diabetes Forum App
 
Hi hale

I noticed you are in Scotland. Me too :smile:. How did you get booked on the Dafne course? It is something I really want to do. Have to confess I haven't spoken to my DSN for about 2 months now :shock:. The last tine I phoned they said I was doing fine, and to be honest I didn't find them a massive amount of help after initial diagnosis and my readings have been pretty stable so I didn't see the point in phoning. However seeing as I was diagnosed a little before you and you are coming out of the honeymoon phase I should probably get back in the loop to be on the safe side.

Sent from the Diabetes Forum App
 
I have been diagnosed for a year now (type 1) and I think my honeymoon period is finally over, my bg readings are down from an average 13 mmol to 6 mmol over the last four weeks. Hba1c done today at the diabetes clinic and it was 5.8% im 14th on the daphne course and will be on it by November next year (no rush there then lol) still some good news at least :grin:

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I thought that when the honeymoon period was ending, your blood sugars would begin to rise rather than come down ? That's what my nurse told me to expect ! Gradually having to inject more insulin to keep within target levels ! Anyone else told same/different ?


Sent from the Diabetes Forum App
 
It's the time where your pancreas is still producing some if its own insulin.
 
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