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The Honeymoon Period in Type 1 Diabetes

In many children, teens, and adults with newly diagnosed Type 1 Diabetes, not all of the pancreatic islets have been destroyed.

In order for the child’s body to exhibit the symptoms of diabetes, approximately 80 percent of the pancreatic islets may have been either destroyed or are non-functional. Therefore, 20 percent of the cells may still be remaining. After initiating insulin, the normal metabolism is resumed and the body starts utilizing glucose as a source of energy. As the blood glucose starts decreasing, the high level of glucose that was bathing and damaging the islet cells in the pancreas automatically decreases too. The remaining islets may begin to recover the ability to produce insulin, resulting in the honeymoon period.
This process does NOT occur in all patients and it sometimes takes several weeks to a month to start.


You have to suspect that your child’s diabetes is in the honeymoon period and inform your diabetes team immediately, once you notice that your child’s blood sugar variability has decreased markedly ,and the blood sugar is in the normal range most of the time. The child may also get frequent episodes of hypoglycemia, if the amount of injected insulin is not decreased . Generally, however, you should keep him on some insulin in order to deter future destruction of those islet cells. There are research studies focused on prolonging the honeymoon period. The honeymoon period also allows for the islet cells to rest as injected insulin is working to assist them. It is unclear how long a honeymoon period may last; it could be several months to more than a year. It is different for each individual with type 1 diabetes.


The question that arises here is how someone can prolong the honeymoon period. Clearly, the longer you prolong the honeymoon period, the longer you have control of blood sugar levels and the chance to delay potential, future complications related to high blood sugars. This is a huge question prompting much funding and research. Doctors and scientists do know that remaining on small amounts of insulin seems to prolong the honeymoon period (to decrease the "glucose toxicity" surrounding islet cells). Other suggestions include the initiation of a low carbohydrate diet. If one consumes low amounts of carbohydrate, less insulin will be required to enable glucose transport into the cells and theoretically this will cause less stress on the islet cells. Ironically, the low carbohydrate diet was the treatment of choice before the discovery of insulin to avoid the symptoms resulting from the inability of the islets to metabolize glucose. These children starved and looked extremely malnourished based on photographs included in past journal articles of the "founders" of insulin, Banting, Best, and Mcleod. I am aware of no studies that have positively demonstrated that a low carbohydrate diet alone will prolong the honeymoon period.

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