Question:
From Dubuque, Iowa, USA:
What is a Type 1 diabetic "honeymoon period?" How long does it usually last?
Answer:
The
honeymoon period
usually refers to a period of decreased insulin
requirements shortly after starting insulin therapy in most cases of Type 1
diabetes mellitus. In these cases there is some restoration of insulin
production and the blood sugar levels improve to normal, or near-normal,
levels. Unfortunately, like other honeymoons, there is a great variability
in its duration and sometimes it doesn't seem to appear at all (as in small
children) or it may lasts for weeks, months, or occasionally (particularly
in older patients) even years. The variability is understandable if you
consider how
long it normally takes for the immunological process that destroy beta
cells of the pancreas to reach the stage of clinical diabetes (so called
pre-IDDM phase).
In the past, there were often pressures to discontinue
insulin in some instances or to go tablets whilst nowadays we know it is
important to keep on with insulin, however small the dose, both for
immunological reasons as well as to prevent false hopes of a cure and to
prevent the risk of triggering insulin allergy and/or resistance. Moreover,
this approach can extend the honeymoon phase, thus increasing the chances of
continued prolonged production of small amounts of endogenous insulin
lasting perhaps for several years with small insulin dose requirements and
better metabolic control.
MS
Original posting 13 Jul 97
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