Type 1 Diabetes Honeymoon Extended
Health-e-Solutions comment: The following excerpts from a very good article on type 1 diabetes offers advice on how to accept the end of a honeymoon period. We think the advice is very good. However, we would disagree with the comment that it is inevitable… that it IS going to happen. Type 1 Diabetes Honeymoon Extended: We prefer to take the position that Dr. Richard Bernstein takes in his book, Dr. Bernstein’s Diabetes Solution. He says,
“I’m convinced the honeymoon period can be prolonged indefinitely. The trick is to assist the pancreas, keep it as quiescent as possible. Limit your total carbohydrate intake to avoid overworking any remaining insulin-producing beta cells of your pancreas. Research has demonstrated that beta cell burnout can be slowed or halted by normalizing blood sugars.”
We do agree with the article’s assertion that a longer honeymoon is better, and that lower A1cs mean less damage to the body. We want to preserve beta cells as long as possible for long term health. We want to provide tighter blood glucose control over a long time to lessen the impact that diabetes can have on the body.
Since January of 2008, we have been managing our boys with type 1 diabetes entirely by a diet and lifestyle that is very low-glycemic and highly nutritious. Their blood glucose levels are within normal ranges most of the time using this natural way of managing their diabetes. We believe this is a big contributing factor as to why we have had such success. If this is still a honeymoon period for our boys, then we are grateful for it, and we hope that it continues for many more years to come. We believe every day we are able to keep the pancreas and the precious beta cells from being overworked is a day of success, whether it includes insulin or not.
Who doesn’t want a honeymoon to last forever? The diabetes honeymoon is no exception. Patients and doctors have long struggled with finding a way to make the honeymoon last. Although there is nothing concrete yet, progress is being made.
Why Longer Is Better
It’s not just about your mental health, your child’s mental health, and giving you all space and time to adapt to life with diabetes, although arguably, those are good enough reasons to extend a honeymoon. A long honeymoon means that your child’s blood sugar average and A1c is closer to the target range for a longer period. Put simply, lower A1cs mean less damage to the body.
Many studies have shown that tighter control over a long time lessens the impact that diabetes can have on the body, particularly the extremities and internal organs.
In addition, a long honeymoon means the islet cells that are still producing insulin may be able to last longer and not work as hard. The longer your child’s body can produce its own insulin, the better off he is. Not only will he need less injected insulin, but he could hold on to insulin-producing cells for a time, in the future, when scientists may know how to help those cells regenerate.
How to Extend the Honeymoon
While it may seem like a nice goal not to have to give insulin at all, many experts agree that some amount of insulin, even the tiniest bit, is good for your child. This is because you don’t want the remaining cells to overwork themselves and die too quickly, and because your child’s body absolutely needs to have enough insulin at all times. Honeymoons can be tricky: the body can work in bursts and breaks, and sometimes, you’ll have no idea what that pancreas is doing or thinking. With an insulin plan, you’ll at least make sure that your child’s body always has insulin of some kind in it, avoiding major highs and diabetic ketoacidosis.
When It’s Over
It’s going to happen. It might happen quickly, but more often it’s a slow realization: The diabetes honeymoon is over. How long it takes to get to that point is part chance, but how you react to it is all skill. Handling this time with both emotional and technical skills is a challenge, but [it is] one you must face.
Honeymoons can last from a month to as long as a year and a half. Some doctors claim to have seen rare cases that lasted as long as three years. One Boston physician tells of a patient whose honeymoon lasted a full six years. On average, though, if your child experiences a honeymoon, expect it to last from six months to a year at best.
As time goes by and you settle in, you’ll begin to notice more spikes in blood sugars and/or a need for more insulin to cover carbs. You’ll look at your week’s logbook and begin to see trends. Usually lunch and dinner are the first times to show spikes in blood sugars, but each child is different. As you see these trends and talk to your team about upping doses, the realization will begin to set in for you, your child, and your team that the honeymoon is ending.
Timing of the honeymoon’s end can sometimes be complicated by timing in life. For instance, most children’s insulin needs go up when school starts (there is more downtime and less outdoor frolicking). You may think that the honeymoon is ending when it’s actually just a normal life-adjustment time that you’ll come to expect every year.
Accepting the End
Parents and caregivers, even more than children, have a hard time accepting the end of the honeymoon and the beginning of the rest of diabetes. First, parents who were sure they could master diabetes to the point of practically non-diabetic averages find out that in fact, nature can be a bear when it comes to blood sugars. If you feel let down, talk to someone, either in your support group or on your health team. She’ll tell you that you are not alone; more than one parent has been fooled by a nice honeymoon. She’ll also remind you of how well you used that honeymoon time and how much you’ve learned.
It can also be difficult to accept that you’re going to have to deal with some erratic blood sugars from time to time. Soon, gone will be the days when your heart nearly stops at a 300. Yes, you’ll still react quickly and treat it as it should be treated, but in the end, you’ll remember that diabetes is a marathon, not a sprint. Some miles you’re going to stall a bit on; others you’ll fly through. Honeymoon or not, it’s all about the finish line. With your child, you are doing all you can to find the pace that makes the run a pleasant and healthful one for both of you.
Health-e-Solutions comment: Until #CuringType1Diabetes is a reality within our reach, put your body in a position of strength to #MasterDiabetes the healthiest way possible. Lifestyle innovations as a priority over drug therapies may be the solution. Poor health feeds poor health in a vicious cycle, or negative feedback loop that is increasingly difficult to break the longer it continues. Promoting, supporting and creating health set in motion a positive feedback loop instead.
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