Q: My son was recently diagnosed with type 1 diabetes, but instead of wildly fluctuating blood sugar numbers, his levels have been fine -- and his insulin use is actually minimal. We were told this is a "diabetes honeymoon." What does this mean, and how long will it last? Some days it doesn't even seem like he has diabetes.
A: Type 1 diabetes develops when the immune system mistakenly attacks beta cells in the pancreas that produce insulin. At the time diabetes is typically diagnosed, it is believed that anywhere from 80 to 95 percent of beta cells have been destroyed.
What happens to the beta cells that are left? To simplify a pretty complex process, when someone with type 1 diabetes first starts taking insulin, the work load on the remaining beta cells to produce insulin is lessened. Along with several other changes, the end result is a partial remission, better known as the "honeymoon phase" of diabetes, a nickname coined in the 1920s and 30s when insulin injections were much more onerous to give than they are today.
Starting insulin therapy and getting blood sugars into a more desirable range can have an effect within a couple of weeks. But the honeymoon phase is known to have its strongest impact several months after diagnosis. Though small in total number, remaining beta cells may produce enough insulin to provide for a certain degree of blood sugar management for many months.
The typical honeymoon lasts anywhere from weeks to months -- until whenever these beta cells come under autoimmune attack and disappear. In teenagers and adults with newly diagnosed type 1 diabetes, honeymoons can be dramatic, lasting in some cases for up to a year or longer.
This temporary phase can feel like a bit of a honeymoon for parents as well -- or probably more like a respite. If you have experienced significant stress since your son's diagnosis, use this momentary calm as a chance to catch your breath and regroup. This is also a great time to learn as much as possible to best manage diabetes when the honeymoon's over. What's most important is maintaining normal care routines. Even if blood sugar numbers are not fluctuating very much, testing and treating remain critical. Developing good habits now will keep you prepared to adjust your son's treatment as needed.
The honeymoon phase will pass, and it's important to look for changes in blood sugar patterns as the first evidence of its imminent departure.
For your son's sake, understand that a honeymoon coming to its conclusion does not mean that the diabetes is getting "worse" or that his numbers are getting "bad" again. From beginning to end, this entire process is simply the natural and expected course of diabetes. No more, no less.
--Stephen Ponder, M.D., F.A.A.P., C.D.E., is a board-certified pediatric endocrinologist in Temple, Texas. He has had type 1 diabetes since age 9.
How Other Parents Deal
"What I learned from my son's honeymoon of about six months is that it's really easy to send a child signals that read as, 'You're getting better! The diabetes is going away!' Sure, it's okay to feel relieved, but skip the celebration and just keep checking blood sugars."
--Jennifer B., mom of Evan
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.