Extended honeymoon period

[Morgan444]

Hi

Has anyone else experienced an extended T1D honeymoon period like I appear to be?

I was diagnosed in October 2021 and put straight on insulin but I find it really difficult to gauge how much basal to give myself as, from time to time, my pancreas appears to kick in and start producing some itself. For example, until around 2 weeks ago I thought I was on a stable dosage of 20 units in the morning and 22 at night but i have had to reduce this significantly and had a night-time hypo last night on only 14 units. Perhaps I should be thankful that my pancreas hasn’t totally given up the ghost but it’s incredibly frustrating as I don’t know how much to give myself.

 

[Inka]

Hi @Morgan444 Yes, the honeymoon can be a frustrating time. Mine went in for approximately 7 years. At least we have Libres, Dexcoms and other CGMs to help us now. This makes things easier.

Anything can affect insulin doses (almost!) - heat, stress, activity, weight, digestion, etc etc. Have you done a recent basal test to see what that tells you? Yes, I know it might change again, but it can be useful to do just to keep an eye on where you are.

Are you on Levemir? What time do you take your doses? What time in the night was your hypo?

 

[Tdm]

I was diagnosed about the same time as you, and whilst i use fairly ' normal' amounts of bolus insulin, i am on 2 units of abasaglar. I presume this is the honeymoon.
Because i am on so little it can be hard to adjust. I revently had a week or two of going low overnight, which was fixed by changing to a lighter duvet...go figure

 

[Morgan444]

Hi @Morgan444 Yes, the honeymoon can be a frustrating time. Mine went in for approximately 7 years. At least we have Libres, Dexcoms and other CGMs to help us now. This makes things easier.

Anything can affect insulin doses (almost!) - heat, stress, activity, weight, digestion, etc etc. Have you done a recent basal test to see what that tells you? Yes, I know it might change again, but it can be useful to do just to keep an eye on where you are.

Are you on Levemir? What time do you take your doses? What time in the night was your hypo?

Thanks for this, really reassuring. I know what to do, just wanted some reassurance that other people have experienced the same. The websites suggest that the “honeymoon period” is a good thing but to be frank, I’d rather just know where I stood with dosages!

 

[rebrascora]

I find increased exercise/activity during the day will cause my levels to drop during the night more than whilst I am exercising, so if you had a particularly active day, it might be that, rather than your own pancreas chucking out some extra insulin. I always have to reduce my evening Levemir dose after a physically active day and two such days in a row will need a further reduction and 3 days in a row and I am down to no evening Levemir at all and sometimes I can still hypo with none, yet my daytime needs stay pretty stable at about 22. We are all different and you have to try to figure out what might be causing it but I would be surprised if your own pancreas is chucking out insulin in the middle of the night without a trigger like food or high BG levels.
Alcohol can also drop levels overnight so that might be something else to consider as a possible cause if you had a drink and it doesn't have to be all that much.

With basal doses near 40 units a day, I would be surprised if you are still in the honeymoon period unless you are a large build and/or have some insulin resistance.

 

[rebrascora]

Thanks for this, really reassuring. I know what to do, just wanted some reassurance that other people have experienced the same. The websites suggest that the “honeymoon period” is a good thing but to be frank, I’d rather just know where I stood with dosages!

I think for some people the honeymoon period can be a good thing and there was a girl on my DAFNE course whose levels were always perfect because her own insulin was buffering the injected insulin but I think many of us find it a total nuisance and I am much happier now that mine is finished..... or as finished as any of us can assume it is.
There was a study done in America on people who had had Type 1 for 4 or 5 decades and it found that they were actually still producing a little insulin themselves even after all that time, but I guess there is a point where it just ends up a tiny trickle rather than being able to dump anything significant into the mix.

 

[Inka]

Thanks for this, really reassuring. I know what to do, just wanted some reassurance that other people have experienced the same. The websites suggest that the “honeymoon period” is a good thing but to be frank, I’d rather just know where I stood with dosages!

Although it is awkward, in my opinion it is a good thing. I noticed that control was harder after my honeymoon ended, like I could feel the constant push to go high, whereas I hadn’t noticed that so much during my honeymoon. It was after the honeymoon that I felt the ‘power’ of the diabetes, if that makes sense.

 

[nonethewiser]

Can't recall how long it lasted, remember doses decreasing to next to nothing then started to increase again, found HP to be right pain so was pleased to get shot of it.

 

[trophywench]

There was a study done in America on people who had had Type 1 for 4 or 5 decades and it found that they were actually still producing a little insulin themselves even after all that time, but I guess there is a point where it just ends up a tiny trickle rather than being able to dump anything significant into the mix.

In fact, it was a study over at least 60 years undertaken by the Joslin Institute in Boston, Massachusetts who followed a cohort of T1 children living in Boston at the time of their diagnosis for as long as those people were able to still travel there once every 5 years or so and let themselves be tested for this that and the other whilst royally entertaining their other halves - I know this simply because we had a member - Richard 137 (- or maybe 157) who kept us posted about it all until he was well into his 70s, when he also told us that he wasn't still producing any insulin and never had really, but others his age still did. Nowhere near enough to be of any practical use to them, but a tiny trickle nevertheless. I have no idea when they started doing it. By this time, he'd had enough of being poked and prodded, plus his wife by then was not in the best of health either, so he didn't think they'd be going again, even if invited to do so. ISTR he could have started before he did, but they were raising children and he also worked so maybe not convenient since although the wives/husbands were catered for I doubt kiddies would have been. (They'd probably have been bored out of their brains anyway!)

 

[Bubbleblower]

There was a study done in America on people who had had Type 1 for 4 or 5 decades and it found that they were actually still producing a little insulin themselves even after all that time, but I guess there is a point where it just ends up a tiny trickle rather than being able to dump anything significant into the mix.

Interestingly, one of the things they found was even a very small amount still had significant impact.
Also because of that they are now taking "mody kind of" type 1's of insulin here.

Stubborn as I am I don't believe in the concept of honeymoon period, but if there was such a thing I would be in it.