Honeymoon phase - how to know you are in it?

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MollyBolt

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I’ve read a reasonable amount about the “honeymoon period” for T1 diabetes. This has made me worried that I might be in one, and then suddenly T1 is going to be come even more grim. How do you know if you are in a honeymoon period? All the chat seems to be that it’s easier to manage T1 during the honeymoon - but this implies you are able to recognise how much worse it can become!

This is what my 7 day patten looks like if that’s able to help anyone advise… Worth saying that I definitely look at my CGM app more than I should and so the lows and highs are carefully managed / avoided.
 

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I’m not sure I would know about anyone else, but I can sort of describe what happened to me…

InitiallyI was on mixed insulin, and given fixed doses, with a carb count to be hit but not exceeded at each meal, and for snacks in between - to ‘feed’ the activity of the insulin. These were expressed in ‘exchanges’, each exchange was 10g carbs. After a few months my doses were renewed.

Once I was switched to MDI, the meal estimates (exchanges) remained the same, but I was given fixed doses to match them at each meal. Then doses were reviewed again. Along with seemingly ad-hoc suggestions of changing the amount of basal I took.

What I noticed during the first year or two was that my insulin needs seemed to increase. And then, after a while they stopped creeping up and settled into a rhythm of ‘up a bit… down a bit” as the weeks and months and then years passed. But the overall average TDD more or less stabilised after a while. It stopped getting substantially larger.

I was given the impression that the early increases were most likely due to a few more beta cells being splatted by my immune system.

I suspect I may still have a tiny trace of residual beta cell function (as I was diagnosed in adulthood), but have never to my knowledge had a cPep to check.
 
I don't know that I ever had one! Nothing noticeable's ever happened to my BG control to be honest.
 
MollyBolt said:
but this implies you are able to recognise how much worse it can become!
Click to expand...

Not always! Some people have a rough ride in honeymoon, with their remaining, flagging, beta cells sort of sputtering back to life, and splurging out home-grown insulin at irregular intervals. For some members over the years it has been a relief when things settle down and they can just rely on the insulin they *know* they are putting in!
 
The honeymoon period is simply the early months and years after diagnosis, when you have some remaining insulin production. For some people it makes it easier to manage and for others it can make it more difficult and erratic. Generally you will have an idea that your honeymoon period is coming to an end when your insulin needs increase. It can last from a month or two to several years and maybe even decades for people with LADA. Mine lasted about 2 years which is fairly average I believe and seemed to have 3 phases where my insulin needs increased. In my case, my basal doses needed increasing over a month or 2 and then settled down at the new dose for a few months and then after about 6 months I started to need more again. for the past 3.5 years my basal needs have been more stable give or take exercise and insulin and summer or winter adjustment, so I assume it is finished but I can never be totally sure (without a C-peptide test) that there are not some beta cells hiding out somewhere in my pancreas, producing a little bit, but I think if there are it is likely negligible now.
 
My honeymoon period ended gradually @MollyBolt and it was only in retrospect I realised it had happened, so don’t worry. Take the insulin you need each day and repeat.
 
I found that my insulin doses gradually needed to increase, but also for wpquite a while things were just frustrating,y unpredictable. Hypos would appear from nowhere when , I assume, my remaining beta cells decided that they had a rest and wanted to play again. I am definitely one of the people that @everydayupsanddowns described as being relieved when the honeymoon period ended. This was when things just levelled out and random hypos reduced in number.
 
MollyBolt said:
I’ve read a reasonable amount about the “honeymoon period” for T1 diabetes. This has made me worried that I might be in one, and then suddenly T1 is going to be come even more grim. How do you know if you are in a honeymoon period? All the chat seems to be that it’s easier to manage T1 during the honeymoon - but this implies you are able to recognise how much worse it can become!

This is what my 7 day patten looks like if that’s able to help anyone advise… Worth saying that I definitely look at my CGM app more than I should and so the lows and highs are carefully managed / avoided.
Click to expand...
I was diagnosed, 42yrs ago, heard of honey moon period, even then .
Unsure if this happened? Only odd experience, was 3 months in, felt unwell, with strange inability to speak properly! I'd wake up fine, but each evening, something happened to my speech? This went on for approx two weeks. It was a horrible feeling in my tongue, n as said, I was OK in day, but it would happen each evening. Still have no explanation of what or why this happened??Recall my parents calling G.P..who visited, they used to do home calls, back then..he tested my blood, it was perfect but he couldn't say why my tounge/ speech weren't normal??
 
This is a very tricky phenomenon and is still happening to me now - I am two years since diagnosis, and was taking tiny amounts of insulin for food, 1u to 20g carbs, since diagnosis, just 6 months ago - I have now doubled this amount to 1:10 to avoid the spikes which were getting out of control but have done it gradually as I was getting quite a few lows as my insulin sensitivity was very high initially - it has now calmed down a lot and I am a lot more in control, and am pleased that it has - that said, I am still on a very low basal insulin (6u a day) and have not needed to adjust this at all - it's as if my pancreas is ok (for now) with the day to day stuff but is not coping with mealtime carbs so much now, hence the bolus doubling of dose - it's weird but I'm glad its settled down (for the time being!) - I've just checked my graph for today and it's the 1st time I've been 100% in range for about 18 months (see attached) and I do put that down to the change in ratios I've made as my honeymoon period is coming to an end - if you check your CGM regularly as you say you do (I do as well, have it on my phone with always on notification and my watch too, with a graph!), you will defnitely know when its changing!
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I have just come out of the honeymoon phase. I was diagnosed with Type 1 in August 2023, and found my blood sugar extremely easy to manage. I almost never used bolus insulin, unless I was having a big plate of pasta or something. In fact, hypoglycaemia was always an issue. I dealt with carbs by going for a brisk walk after the meal, in lieu of using insulin, and that reliably brought my blood sugar down. If I walked too far and too fast, my blood sugar would plunge into dangerous levels.

A month ago I did a difficult international trip (difficult because I was exhausted from jet lag and having to do business meetings and eating crappy food) and noticed my blood sugar was swinging wildly. Now I just have to look at carbohydrates and my blood sugar goes sky high. I use far more insulin than I did and never, ever get hypoglycaemia.

I have been shocked at how difficult this disease has suddenly become. My goal now is to do weight training to build muscle, to keep my insulin needs as low as possible.
 
I can concur with a few others on here - it was probably about 2 years for me. I can sympathise with the unexpected effects of the pancreas kicking into life and producing a smattering on insulin.

I was on a mixed insulin at first as per @everydayupsanddowns; referred to 6 months in by a new DSN as the 'granny in a care home regime'. My levels were consistently stable, with HbA1c averaging around 40-42. Once I was popped onto on a basal bolus regime and then using Libre, I continued to have stable periods, but some really random highs and lows. It felt like I was regularly chasing my tail, seeking some sort of stability. A bolus of 1 unit to 10 grams of carbs worked perfectly one day and then caused a hypo the next. The worst was my wife once finding me in the early hours of the morning, sitting on the kitchen floor attempting to open a cupboard (magnetic childlocks on the cupboards at the time) clearly trying to get jelly babies, delirious and muttering "I'm sick". Basal and bolus doses needed careful monitoring and adjusting in consultation with my DSN and consultant too.

Things improved though. After a couple of years the honeymoon period/ random hypos ceased. However, like @MarinaDE has mentioned, after 6 years I am now trying to cope with the 'highs' - HbA1c around 52.
 
I think I'm almost through it (no ridiculous highs or lows for no reason) - my best two days ever this week! - I'm sure it will change again though - good luck to everyone going through the "Honeymoon Period" (Not a phrase I would have used!) - 2 years for me
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