How will I know I’m in the honeymoon phase?

[CelalDari]

I am newly diagnosed T1 about 2 months since my diagnosis— still waiting on C-peptide!!! I was having frequent hypos (1-3 times a day) when I was on 16u of Lantus but reducing it down to 14u has dramatically reduced the number of hypos.

My question is how will I know if I am in the honeymoon phase? I’ve heard contradicting stuff about the honeymoon period. Some people say it’s easier to control BG because your pancreas is still producing some insulin while others say it’s harder to control because it gives them frequent hypos. Also how common is the honeymoon period because I had diabetes symptoms for months and months but I guess I got used to frequent urination and thirst, never really had a dramatically increased appetite. I’m guessing I’ve probably had it for nearly a year. The strange thing is, around 2 years ago I lost a lot of weight 86kg to 70kg (-16) in a year without any dieting or exercise. For some time I gained a lot of it back to 83kg then afterwards it went down and down to 55kg. Could it be that I had T1D then it went into remission then started again? Seems unlikely. I know the honeymoon phase occurs because there’s less stress on the pancreas but it seems strange that I lost and gained weight so dramatically.

My GAD antibodies came positive, Im not sure if that confirms my diagnosis or not because how comes I was losing weight, getting dehydrated for 10-11 months with probably sky high ketones yet I didn’t have severe DKA symptoms

 

[ert]

Your c-peptide with your fasting glucose will help give a clearer picture and treatment path.

 

[michita]

Since diagnosis 4 years ago I’ve gradually increased my basal insulin from 2 units to 16 units a day now. If you are injecting 14 units now and managing ok and you don’t have to gradually increase the dose further it probably means you are not in the honeymoon period but we’ll never know for sure.

 

[UK T1]

Hi, just read your other thread re honeymoon and insulin doses. It isn't really something anyone on here can answer, other than sharing their experience, but then diabetes is very very different for different people.

I have no idea re your weight loss and diagnosis. When I was diagnosed I hadn't lost weight (eating enough for a rugby team saw to that, as my mother so kindly reminds me but I was admitted to HDU for about a week with DKA. My HbA1c was one of the highest my clinic said they'd seen, and so they thought I'd had it for at least 10+months. As such, I did not seem to have any honeymoon phase. I don't know whether I would have done if I had been diagnosed earlier.

Re insulin doses, I take a different basal from you, but at roughly the same mass as you, I take a total of 14u levemir a day. This is not an indication of my insulin production (tests say this is non existent). It will partly depend on your exercise levels, other conditions and diet.

Everyone is different so has to manage their diabetes differently. While there are average guidelines for doses, there will always be people who need more, or less than those guidelines. I do a fair bit of exercise which makes you more sensitive to the insulin you inject. I also don't have any other conditions which might increase insulin resistance. Hearing some stories on here about people who have followed their diabetes team's advice and really struggled to get stable bloods, it sounds like I've been fairly lucky in mostly having expected responses to my meds!

The early months will be a steep learning curve, finding the right balance for you. Most people have hypos and hypers galore while they're trying to figure out how their body reacts to different aspects of their lifestyle. While hypos feel horrible, it is also fairly usual, so I would say not conclusive evidence you're in a honeymoon period. Have you got a blood test booked in?

 

[CelalDari]

Hi, just read your other thread re honeymoon and insulin doses. It isn't really something anyone on here can answer, other than sharing their experience, but then diabetes is very very different for different people.

I have no idea re your weight loss and diagnosis. When I was diagnosed I hadn't lost weight (eating enough for a rugby team saw to that, as my mother so kindly reminds me but I was admitted to HDU for about a week with DKA. My HbA1c was one of the highest my clinic said they'd seen, and so they thought I'd had it for at least 10+months. As such, I did not seem to have any honeymoon phase. I don't know whether I would have done if I had been diagnosed earlier.

Re insulin doses, I take a different basal from you, but at roughly the same mass as you, I take a total of 14u levemir a day. This is not an indication of my insulin production (tests say this is non existent). It will partly depend on your exercise levels, other conditions and diet.

Everyone is different so has to manage their diabetes differently. While there are average guidelines for doses, there will always be people who need more, or less than those guidelines. I do a fair bit of exercise which makes you more sensitive to the insulin you inject. I also don't have any other conditions which might increase insulin resistance. Hearing some stories on here about people who have followed their diabetes team's advice and really struggled to get stable bloods, it sounds like I've been fairly lucky in mostly having expected responses to my meds!

The early months will be a steep learning curve, finding the right balance for you. Most people have hypos and hypers galore while they're trying to figure out how their body reacts to different aspects of their lifestyle. While hypos feel horrible, it is also fairly usual, so I would say not conclusive evidence you're in a honeymoon period. Have you got a blood test booked in?

I don’t have a blood test booked in but my HbA1c was 134 in April and then 84 in May, I have no idea what it is right now. I have an appointment with my diabetes consultant in a month so I suppose they will do bloods then before the appointment.

At the moment my diabetes seems very manageable and I’m wondering if I am in the honeymoon phase. I’m worried that it’s going to get much harder over time. I weigh my carbs, never guess and use a 1:10 ratio while prebolusing for all high carb meals.

I really don’t want it to get harder. I don’t have the time and effort to use different ratios, always be diabetes-centered. I’m about to start university and will also be employed in a laboratory.

I’m also desperate for an insulin pump, any diabetes technology that can make my life easier really and I know you need to be out of the honeymoon phase and already been through a DAFNE course. The coronavirus situation is also delaying everything. Seems impossible to be honest, I should give up now

 

[UK T1]

I don’t have a blood test booked in but my HbA1c was 134 in April and then 84 in May, I have no idea what it is right now. I have an appointment with my diabetes consultant in a month so I suppose they will do bloods then before the appointment.

At the moment my diabetes seems very manageable and I’m wondering if I am in the honeymoon phase. I’m worried that it’s going to get much harder over time. I weigh my carbs, never guess and use a 1:10 ratio while prebolusing for all high carb meals.

I really don’t want it to get harder. I don’t have the time and effort to use different ratios, always be diabetes-centered. I’m about to start university and will also be employed in a laboratory.

I’m also desperate for an insulin pump, any diabetes technology that can make my life easier really and I know you need to be out of the honeymoon phase and already been through a DAFNE course. The coronavirus situation is also delaying everything. Seems impossible to be honest, I should give up now

It does not have to get harder. There are plenty of people who didn't find that it gets harder. As others have said, plenty find the honeymoon phase difficult if their pancreas sporadically releases insulin which they can't plan for. I am glad you have found it manageable!

I don't know if you can find out if you are in the honeymoon phase or not, but many find the beginning just after they were dianosed the hardest time, so if you're already finding it manageable you're in a good place! I found the first month or two the hardest for me, I learned a lot, realised I maybe needed to be organised in future (always have hypo treatment on me for example) but then everything just became second nature. The beginning is daunting and a steep learning curve but there is no reason why that should get harder or continue. Congratulations for getting into Uni! I also went to Uni (as did many on here) and did not find my diabetes restricted me at all. There is no reason for your life to be diabetes-centred in the long run. The beginning is a steep learning curve, but it will become second nature soon

 

[Daibell]

I am newly diagnosed T1 about 2 months since my diagnosis— still waiting on C-peptide!!! I was having frequent hypos (1-3 times a day) when I was on 16u of Lantus but reducing it down to 14u has dramatically reduced the number of hypos.

My question is how will I know if I am in the honeymoon phase? I’ve heard contradicting stuff about the honeymoon period. Some people say it’s easier to control BG because your pancreas is still producing some insulin while others say it’s harder to control because it gives them frequent hypos. Also how common is the honeymoon period because I had diabetes symptoms for months and months but I guess I got used to frequent urination and thirst, never really had a dramatically increased appetite. I’m guessing I’ve probably had it for nearly a year. The strange thing is, around 2 years ago I lost a lot of weight 86kg to 70kg (-16) in a year without any dieting or exercise. For some time I gained a lot of it back to 83kg then afterwards it went down and down to 55kg. Could it be that I had T1D then it went into remission then started again? Seems unlikely. I know the honeymoon phase occurs because there’s less stress on the pancreas but it seems strange that I lost and gained weight so dramatically.

My GAD antibodies came positive, Im not sure if that confirms my diagnosis or not because how comes I was losing weight, getting dehydrated for 10-11 months with probably sky high ketones yet I didn’t have severe DKA symptoms

The positive GAD almost certainly confirms T1. I had serious weight loss and all the other symptoms at diagnosis time. I didn't have a meter and my stupid GP said I was T2. My BS must have been in the 30s at times and I was hyper but I didn't have DKA. My honeymoon lasted over 5 years. The need for increasing your insulin dose will tell you you are still in the 'phase'

 

[Jaylee]

I am newly diagnosed T1 about 2 months since my diagnosis— still waiting on C-peptide!!! I was having frequent hypos (1-3 times a day) when I was on 16u of Lantus but reducing it down to 14u has dramatically reduced the number of hypos.

My question is how will I know if I am in the honeymoon phase? I’ve heard contradicting stuff about the honeymoon period. Some people say it’s easier to control BG because your pancreas is still producing some insulin while others say it’s harder to control because it gives them frequent hypos. Also how common is the honeymoon period because I had diabetes symptoms for months and months but I guess I got used to frequent urination and thirst, never really had a dramatically increased appetite. I’m guessing I’ve probably had it for nearly a year. The strange thing is, around 2 years ago I lost a lot of weight 86kg to 70kg (-16) in a year without any dieting or exercise. For some time I gained a lot of it back to 83kg then afterwards it went down and down to 55kg. Could it be that I had T1D then it went into remission then started again? Seems unlikely. I know the honeymoon phase occurs because there’s less stress on the pancreas but it seems strange that I lost and gained weight so dramatically.

My GAD antibodies came positive, Im not sure if that confirms my diagnosis or not because how comes I was losing weight, getting dehydrated for 10-11 months with probably sky high ketones yet I didn’t have severe DKA symptoms

Hi,

It's difficult to guess. & a couple of tests should help you find out what's going on.

I got nearly 44 years of T1 under my belt. My weight has never fluctuated much so on the face of it you & I am aprox a similar build to yourself. (However, not all metabolisms are quite the same.)

Regarding your insulin IC ratio. Mine is the same.
I also take Lantus. We share the same amount on dosage. Anything higher than 14u for me (even on a "sick day.") can drop me. Even on 14u having an active day I can drop.The hypos can be slow creepers on the basal.
But then Lantus is not the most stable basal on the market these days.