Honeymoon period

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.




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.

MarkMunday said:

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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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.

MarkMunday said:

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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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