From Evansville, Indiana, USA:
What is the "typical" duration of the honeymoon period? My son was diagnosed at 5 years old (last February, 1996 [8 months ago]). Recently, his sugars have been consistently running high (250-430's) and he has been requiring additional injections of Regular insulin at lunch and sometimes bedtime to bring his sugars under control.
His endocrinologist has not been very helpful and has suggested that "we don't starve diabetic children" in order to bring their sugars under control. We were wondering if what we have been seeing is the result of ever decreasing pancreatic function and an end to the "honeymoon period". How can one know when this period has ended?
The average duration of the honeymoon or remission period is four to five months; but occasionally it can be as long as several years. The ending of this period is heralded by a gradual rise in insulin requirements to a total of around 0.8 Units/kg. of body weight/day. An infection can end this phase abruptly. As the endogenous insulin supply shrinks, the amount injected has to increase to keep the range of fasting blood sugars within the 80 to 180 mg/dl range or a little higher and to keep hemoglobin A1c levels below the upper range of normal for the method +10%. This needs to be done cautiously in order to avoid hypoglycemia and the fluctuating blood sugar pattern caused by rebounds. A few fortunate individuals seem to be able to supply some of their own insulin for years, maintaining good control on a small amount of injected insulin.
At this stage, you are likely to find more support if you arrange to have your son looked after by a pediatric diabetic team. This consists of one or more physicians with experience in looking after diabetes in this age group, a nurse educator, a nutritionist and a medical social worker. Even if such a group were not accessible to where you live, an annual visit to the nearest one would be a considerable help. The nearest office of the American Diabetes Association should be able to help you find such a group, as would the Pediatric Department in the nearest Medical School.
Original posting 16 Nov 96
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