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Re: [IPk] Honeymoon Period

On 19 Dec 2003 at 9:22, Margaret Reid wrote:

> With the honeymoon period, I wanted to see if we could work out
> whether he was in it, what would be the best thing to do etc
> before consulting the hospital. In the back of my mind I thought
> I had heard of a link between total insulin intake per day with
> weight. ie a unit per kilo measure. In my original e-mail, I
> clearly didn't explain this too well.

Hi Maggie,

There is supposed to be a link between units/kg weight 
though of course it is only an average and people vary. 
According to the book Insulin Dependant Diabetes in 
Children, Adolescent and Adults by Ragnar Hanas, the 
honeymoon period is defined as 0.5 units of insulin per kg 
per day or less (excellent book but hard to get hold of 
BTW). My son, who was diagnosed in March, currently 
maintains excellent BG's (92% in range) very easily on 0.3 
units per kg on twice daily mixed insulin so I think most 
would agree that he is still experiencing honeymoon.

On the other hand my daughter is using around 1.1 units/kg 
on a pump with 75% of BGs in range over the last month 
(compared to around 45-50%. in range on MDI previously). 
Emily came out of honeymoon quite slowly. She was using 0.4 
units/kg 8 months after diagnosis, 0.5 units/kg a year and 
a half after diagnosis and 0.7 units/kg three years after 
diagnosis. Puberty will increase the unit/kg rate which may 
well be affecting my daughters level of insulin use as I 
believe many adults here use less.

If Jamie is still using 30 units and weighs 42kg he is 
using 0.7 units/kg and would need to reduce his insulin to 
21 units whilst maintaining good BG's to be classed as 'in 
the honeymoon period' according to Ragnar Hanas. It doesn't 
mean that he isn't producing any insulin of his own at 
these levels though, and any insulin he produces will help 
smooth out BGs. This is our experience anyway, I believe 
some people have problems with spurts of insulin disrupting 
control rather than helping but it has only been a help 
with my children's control so far. I'm hoping that my son's 
insulin production drops off as slowly as my daughters as 
it will help during the difficult puberty years.

Best wishes,
Mum to Emily aged 11, dx Oct '99
D-Tron Plus pump since 27th Oct,
Robert aged 13 dx Mar '03 
Novomix 30 x 2 (+ Novorapid when hungry!), 
and Matthew aged 8.
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