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Honeymoon period

Discussion in 'Type 1 Diabetes' started by TypeZero., Jul 13, 2020.

  1. TypeZero.

    TypeZero. · Well-Known Member

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    Ok guys this is going to be long stick with me

    Diagnosed 3 months ago and had no noticeable honeymoon period but was told my basal is half of what it should be, it was 14 units. I used a 1:10 ratio for all meals for NovoRapid and it worked perfectly with no hypos apart from a few hypos here and there due to eating high carb meals and insulin kicking in before glucose.


    IMG_1339.jpg

    This is all a bit confusing but I usually take my Lantus at 6am and from my Libre I can see my BG rises steadily from 1am, suggesting Lantus lasts 19 hours for me. So what I wanted to do is take my Lantus in the afternoon so that my Lantus finishes midday on the next day so I can avoid hypos (since I’m more insulin sensitive during midday).

    I tried to do this by skipping my morning dose and instead topping up with NovoRapid when needed. I just arrived into a new country which is about 40 degrees Celsius last night, I slept on 5.5 and woke up on 9.8 but for some reason after bringing my BG back down it didn’t rise at all, it has been 35 hours since my last Lantus dose and I’m currently only on NovoRapid. Lantus lasts 19 hours for me so it has definitely cleared from my blood.

    I’m just so confused. I had a bit of a cough, could an illness distract my immune system from attacking my pancreas or something? Funny how coming into the warm country I suddenly don’t need Lantus?

    I’m reluctant to start Lantus again because of the fear of hypos but has anyone experienced anything of the sort? I mean I’m 3 months in and my pancreas didn’t help me a single bit apart from obviously covering part of my basal.
     
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  2. Rokaab

    Rokaab Type 1 · Well-Known Member

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    How do you know? It could well have been helping but there's absolutely no way to actually tell. Just because your current carb ratio is 1:10 doesn't mean your pancreas isn't helping with your food - there wasn't ratios when I was diagnosed, but I know my ratios now are not 1:10.
    I suspect the way people figure out that they are not in the honeymoon period is when their insulin quantities have to be raised to cope (and not just temporarily).

    It could just be your honeymoon is still going on and sometimes giving more than you realise and other times no help at all, it could be that at the moment, its decided to go help.
     
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  3. In Response

    In Response · Well-Known Member

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    How do you know you have had no noticeable honeymoon period?
    I can only write about my own experience. Whilst, thankfully, I did not experience a "spluttering" pancreas, my insulin dose increased over about 8 years. I was led to believe this was my honeymoon period.
    Perhaps a honeymoon period means different things to different people.

    I find this surprising. I have always been told you need as much insulin as you need to keep your blood sugars stable. I have read about various guides based on weight and ratio of bolus to basal. But these are just guides.
    I am not sure what you mean by "it was 14 units". Are you saying 14 units is half of what you are told it should be?
    As an example ... and I mean "an example' not a guide or a suggestion ... I take 15 units of basal.

    There are many things which affect our blood sugars. Climate is one of these things. Some people find their insulin needs increase when the climate is warmer and some people find their insulin needs decrease in the heat. My theory is it may be related to how comfortable you are with the heat as stress is another thing which affects our blood sugars.

    As there are so many things which can affect blood sugars, I try to draw no conclusions from one meal, one night or one day. I think the true value of a CGM or Libre is not that it saves our finger tips; I think the value of a Libre or CGM, is being able to see trends.
    Personally, I would not intentionally miss my basal dose. If I was concerned my blood sugar was too low, I would take my basal, keep a close eye on my levels and make small tweaks if necessary with bolus and/or carbs.
     
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  4. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    You must be making most of your own insulin, which is what the honeymoon is. The term 'honeymoon' is a bit misleading because you don't know about it until it is over.

    Warmer weather reduces insulin requirement, which is probably why you are noticing it more now. Your doctor thinks a fully insulin dependent male with normal insulin sensitivity and your size would require 28 units of basal (14 x 2), which sounds reasonable. Also note that rising blood glucose in the early hours of the morning does not mean Lantus is finishing. Insulin requirements increase at this time because of 'Dawn Phenomenon'. It is part of the 24 hour circadian rhythm and happens to all of us. People using pumps increase their basal rates at this time.

    Reducing basal as long as blood glucose stays in the target range sounds reasonable to me. Using Novorapid to cover food should suffice as long as endogenous insulin covers basal requirements. You may find your reduced insulin requirement does not last, though, so be vigilant and ready to take corrective action.
     
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    #4 MarkMunday, Jul 13, 2020 at 9:53 PM
    Last edited: Jul 13, 2020
  5. TypeZero.

    TypeZero. · Well-Known Member

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    It’s all a bit strange you see. I suddenly no longer needed Lantus. I was fine with 14 units of Lantus even when I was in the UK and we had heatwaves towards 35 degrees. The current country I’m in is only a few degrees hotter than 35 and suddenly I don’t need Lantus.

    All a bit of a mystery. Maybe I didn’t need Lantus on that day? Anyways I injected my 14 units and will be monitoring my BG constantly nothing too serious should happen if I top myself up with carbs if needed.

    I was in the thought that dawn effect is from 4am whereas my BG rises steadily from 1am.
     
  6. MarkMunday

    MarkMunday Type 1 · Well-Known Member

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    Bear in mind that what happens to blood glucose is the net effect of various factors. Yes, Dawn Phenomenon increases closer to dawn. But Lantus insulin action may be fading at the same time too. And there are probably various other factors, like state of health and stress & exercise during the previous day. The only thing we can be sure of is that there are no simple answers to why blood glucose changes.
     
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  7. TypeZero.

    TypeZero. · Well-Known Member

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    I’m actually so confused don’t even want to think about it anymore. Yesterday I had no Lantus and highest BG was only 10 and that was because I was guessing carbs.Today I had my 14 units of Lantus and my BG is around the same, no hypos. My Lantus is clear with nothing visible within it so it’s not expired. I’m actually so confused as to what is happening. Did I just have a 1 day honeymoon I don’t know
     
  8. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Dawn phenomenon hasn't, thus far, been part of my life, but I have read various people report their own experiences, which tend to vary from one to another, and in some instances, it changes a bit over time.

    I think it's fair to say that one thing living with diabetes tells any of us is that there is no "One Size Fits All", nor is there "One True Way" to manage it. There are just about as many sizes and ways as there are people living with diabetes.

    Were either of those things even a bit true, places like this forum would not exist. There would be no need.
     
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  9. In Response

    In Response · Well-Known Member

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    A type 1 honeymoon is not like a wedding honeymoon. It is not all fun and love.
    A type 1 honeymoon is when your pancreas may be producing some insulin ... and then some days it may not. Unfortunately, this "insulin spluttering" (sometimes it works, sometimes it doesn't) is not uncommon for people recently diagnosed. From what you describe, your experience yesterday is not atypical with someone still on their honeymoon.
    Do not be surprised if you experience more over the next months or even year.

    I think you previously mentioned your endo discussed moving to a pump when your honeymoon is over. This unpredictability is the reason why pumps are usually offered when your insulin needs are more stable and you can see a daily basal need profile ... which is the best thing a pump offers. During the honeymoon period, this insulin spluttering means you have no baseline to start with. as it changes too often.
     
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