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Honeymoon period maybe ending

Discussion in 'Type 1.5/LADA Diabetes' started by spage, Oct 3, 2019.

  1. spage

    spage LADA · Well-Known Member

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    So I got in contact with my community diabetes team as doctors are useless

    Went for a blood test today. By my symptoms and what I’ve told them they suspect my honeymoon period is coming to an end. Not sure how I feel about it as it was expected at some point but we will wait and see
     
  2. Daibell

    Daibell LADA · Master

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    I've been on insulin for the last 5 years of my honeymoon period and needed to increase the Basal dose and Bolus ratio during that time. This has slowed down so that's the measure I'm using to signal 'the end'. I've also doing a c-peptide test (privately) as a x-check.
     
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  3. ert

    ert Type 1 · Well-Known Member

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    I was diagnosed with type 1 rather than LADA with a c-peptide below 0.2 nmol/l but I managed to stay off insulin for 2 years on honeymoon by not eating carbohydrates. During that time I had my c-peptide monitored every three months. I also tested my blood sugars at least 5 times a day and my blood ketones when my blood sugars stayed high and I felt unwell. It was clear when my honeymoon had ended. My c-peptide fell below 0.07 nmol/l and I couldn't get my blood sugars below 13 mmol/l and my ketones were building above 3 mmol/l. I walked into A&E and started insulin.
     
  4. jamesfitz

    jamesfitz Type 1 · Well-Known Member

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    stay on insulin from day 1 to extend the honeymoon period
     
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  5. martijnpeters

    martijnpeters Type 1 · Newbie

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    Why is that? It sounds counter intuitive to me; doesn't insulin cause your immune response to attack the beta cells?

    I'm in my honeymoon period myself and since my diagnosis almost 2 years ago my HAb1c have been perfect (36) by eating low carb (was wrongly diagnosed type 2 at first).

    I asked my doctor if using insulin wouldn't increase the decline of beta cells, but she couldn't answer that question.

    If you or someone else have a scientific source saying that starting with insulin from day one would increase the honeymoon period, I'm really interested :)
     
  6. Circuspony

    Circuspony Type 1 · Well-Known Member

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    There's quite a bit if you get on google.
    This one talks about it a bit and refers to more articles https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900074/

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811444/
    Overall, these results are encouraging because they imply that the insulin-treated patients maintain better β-cell function. The optimal insulin regimen is not clear. Given that the loss of rapid insulin release occurs early in LADA, replacement with fast-acting insulin might be beneficial. However, from a practical point of view, it might be difficult to initiate multiple insulin injection therapy in LADA patients, especially if their blood glucose levels are moderately increased. Thus, a long-acting insulin injection might be a good alternative.
     
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  7. ert

    ert Type 1 · Well-Known Member

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    Interestingly, my specialist believes that the end of my honeymoon period correlated with another immune response of higher GAD antibodies rather than high blood sugars and beta-cell fatigue as the article posted above suggests. I had almost normal Hb1ac during that time.
     
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  8. jamesfitz

    jamesfitz Type 1 · Well-Known Member

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    basically by manually injecting insulin the beta cells dont have to work hence they are "hidden" preventing further attack. Couldnt tell you where i read it, i am 4 years in to my honeymoon though on fast acting insulin only with average blood sugar of 5.5 mmol since diagnosis
     
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  9. Ian DP

    Ian DP LADA · Well-Known Member

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    [QUOTE="martijnpeters, post: 2164666, member: 472544"I asked my doctor if using insulin wouldn't increase the decline of beta cells, but she couldn't answer that question.

    If you or someone else have a scientific source saying that starting with insulin from day one would increase the honeymoon period, I'm really interested :)[/QUOTE]

    have a read of dr Bernstein’s Diabetic Solution (kindle just a few ££s). His solution is to keep to ‘normal’ 4.2 to 4.6 percent range and you could stay in the honeymoon period for 10 years or longer. I have been trying to follow his solution for nearly 6 years now. Still in the honeymoon period. He states, start insulin very early.... to keep in ‘normal’ range.i started when my big levels started to rise above 6. Should have started earlier, when I couldn’t keep them at 5.0...... the most important thing is to keep big levels low, and insulin helps achieve this.
     
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  10. Jillyfl

    Jillyfl LADA · Well-Known Member

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    What is the honeymoon period? I’m newly diagnosed LADA and was put on insulin straight away
     
  11. Ian DP

    Ian DP LADA · Well-Known Member

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    LADA generally refers to a new diagnosed T1 who is still producing some insulin... my understanding. So, if you very low carb you might... just might... be able to survive without insulin for a few years, but eventually will need insulin. I did 3 years without insulin, I now take insulin (to keep my BG at normal levels) and have done so for 3 years. I am still in the honeymoon period, because, although taking insulin, the amount I inject is less than normal because I am still producing some natural insulin, all be it less than I was when first diagnosed 6 years ago. Generally speaking, the lower carb you take, the longer you can stay in the honeymoon period, this because it is generally found easier to keep BG levels at normal levels when on a low carb diet. In my opinion, best book to read and understand this is dr Bernstein ‘my solution’
     
  12. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    @ian DP are you in the UK? I ask because my bg readings are trending more and more often over 6, but I was assuming my GP would balk at prescribing insulin until my numbers get much higher.

    Like you I am most influenced by Dr Bernstein. Anyone hesitating to buy his great classic book can read quite a lot of it online at his site http://www.diabetes-book.com
    or listen to the Q&A sessions he still gives every month. They are all on Youtube:
    https://www.youtube.com/playlist?list=PLs_TA02I6IvV6-1s2pL4BPhvMo0Ck_lcY
     
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  13. Sazla

    Sazla · Member

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    Hi, this is my first post here. I’m type 1 diagnosed 6 months ago. This is all very interesting reading to me. I’ve found that the kinder I am to my pancreas the better it performs. If I eat little and often, avoid high carb I need v little short acting. If I don’t then I need proportionally more short acting and I struggle to keep control. I’ve ended up here today as Christmas indulging has sent me hay wire and I’m looking for guidance.
     
  14. Alexandra100

    Alexandra100 Prefer not to say · Well-Known Member

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    Hello @Sazla, you are seeking guidance, but your post might help guide me. Could you say, how little and how often?
     
  15. Ian DP

    Ian DP LADA · Well-Known Member

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    Hi Alexandra,
    Yes, in the UK. But my GP practice don’t get involved in my diabetes, I am under my local hospital (Addenbrookes). They are very good and understanding about low carbing. I asked for a insulin pen sometime beforehand, and was given one (Novo rapid) with no problem, on the understanding that I would only inject 1 unit at a time, before meals, if my BG levels were over 6. Now, if they were 5, I would inject 3 units, to cover a main meal. But my advice would be to start slowly.
     
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  16. Ian DP

    Ian DP LADA · Well-Known Member

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    Hi Sazla. I find if I over eat, even very low carb, it raises my BG levels very slowly, and this is probably because of the protein. 2 hours after a meal my BG levels will often be around 5, then 2 hours later, without eating or drinking, they will often be at 6. This occurs when I eat excessive quantities of meat or fish, as I did at Christmas. I am convinced that whilst LADA, the kinder you are to your pancreas the longer you will stay in the honeymoon period. Being kind to you pancreas means keeping your BG levels low.... keeping control.
     
  17. Sazla

    Sazla · Member

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    I’m so new to all this so haven’t really considered protein and it’s effect. In everyday life I’m v active and controlled in how I eat so Christmas with excesses and sedentaryness (so not a word?!) has had a huge effect on blood sugar. It’s diificult as I just want to let my hair down but I’m not sure it’s worth the repercussions. Glad I’ve decided to post here as diabetes is a very solitary thing
     
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  18. Sazla

    Sazla · Member

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    Hi Alexandra. I try to put a positive slant on the food I eat and choose to eat high quality natural stuff. Every couple of hours I have a snack of approx 15g (snack bar, fruit etc). Whether or not I take insulin is dependent on where I am (bg wise) at the time. I have a small holding and do dog walking so I’m pretty active. On sedentary days it’s a very different story. The key to control for me is frequent testing and I look forward to getting the libre full time (I’ve only carried out a trial up until now)
     
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  19. Hertfordshiremum

    Hertfordshiremum · Well-Known Member

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    Hi Could I ask do you eat low carb to maintain average BG of 5.5? I am 1.5yrs after LADA diagnosis and recently had to start Levemir as BG rising without eating. Thanks
     
  20. Ian DP

    Ian DP LADA · Well-Known Member

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    At six months in, you are doing great. It is a learning curve. Keep testing. I would love a libre too. I keep on asking, but they say my BG control is too good!!!
     
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