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From Mesa, Arizona, USA:

My son has recently been diagnosed with type 1 diabetes, and I am assuming he is currently in his honeymoon because each few days that go by, he requires less insulin. I don't know if this is because his blood sugar level is at an amount that his pancreas and insulin can handle, but he has been low everyday (50-78 mg/dl [2.8-4.3 mmol/L]). Does introducing an artificial hormone into the body pretty much in effect guarantee the shut down of the organ that is supposed to produce this hormone similar to what steroids and thyroid pills do?


In general, the honeymoon phase is not really well understood despite the fact that it has been described for many decades. There is some recovery of damaged islet cells function, more recovery with more stabilization of insulin/diet, etc. The honeymoon is less likely to happen in the very youngest patients, and more likely to occur in the teens and adults with type 1 and last a variable period of time. We and most other diabetologists dealing with kids do not stop insulin completely but continue small doses to try to minimize any allergy problems if insulin treatment is interrupted.


[Editor's comment: There's little evidence that giving hormones causes permanent shutdown of the endocrine organ -- in fact, with both steroids and thyroid (the two examples you quote), it's well-known that the adrenal glands (for steroids) and the thyroid gland (for thyroid hormone) will eventually recover full function after long periods of therapy with these hormones (unless some disease had previously caused destruction of the endocrine gland itself) -- which is analogous to the situation in diabetes, where the pancreatic beta cells are gradually being destroyed, and where the hormone insulin is given as replacement therapy. WWQ]

Original posting 15 Nov 2001
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