When someone first receives a diagnosis of type 1 diabetes and starts insulin treatment, their blood sugar can stay at near-normal levels, and their diabetes symptoms vanish. Doctors call this the honeymoon phase.
At this time, a person can achieve near-normal blood sugar with decreasing amounts of insulin, and some manage to stop using insulin temporarily.
In this article, we take a look at the honeymoon phase in diabetes, and how long it might last. We also examine how it affects blood sugar levels and diabetes management.
What is the honeymoon phase in type 1 diabetes?
Man is happy with blood sugar during diabetes honeymoon period
Initial treatment for diabetes can normalize blood sugar, but a person will need insulin for life in the long term.
The honeymoon period can occur right after an initial diagnosis of type 1 diabetes, and when a person starts insulin treatment.
At this time, diabetes may seem to go into remission or disappear.
Type 1 diabetes is the result of a faulty immune reaction against the pancreas, the organ that produces insulin. The immune system usually destroys unwanted substances, such as bacteria, but sometimes it can go wrong and destroy healthy cells instead.
When a person first receives a diagnosis of type 1 diabetes, some of their insulin-producing cells still function. While these cells continue to do their job, the body is still able to produce some insulin.
The need for synthetic or additional insulin may decrease when the person first starts treatment, and some people may be able to stop using it altogether.
This “honeymoon phase” may last from a few weeks to several months but will eventually end. It may seem that the diabetes has gone away, but, unfortunately, this is only a remission.
After a while, the remaining insulin-producing cells will stop working. As the person monitor their blood sugar, they will notice levels rising again. The need for synthetic insulin will increase.
In time, diabetes will destroy all the insulin-producing cells. As a result, the pancreas will no longer produce insulin, and the honeymoon period ends.
The person will not have another honeymoon period and will depend on external insulin.
Eating a healthful diet and exercising regularly can benefit those with type 2 diabetes.
Some people with type 2 diabetes may experience a reduction in symptoms and blood sugar levels after diagnosis, but this is not the same as a type 1 honeymoon phase.
Doctors may advise someone with a new diagnosis of prediabetes or type 2 diabetes to modify their diet and lifestyle. This may include getting regular exercise and eating a healthful diet. These changes can lower a person’s blood glucose levels.
However, if the person stops these healthful habits, blood glucose levels can rise again. The idea that people with type 2 diabetes can develop type 1 diabetes when they take insulin is a myth.
Honeymoon period duration
Diabetes affects individuals differently, and the honeymoon phase, too, varies between people. There is no standard time for it to last, and not everyone with type 1 diabetes will experience it.
The honeymoon phase usually occurs in the first 3 months after diagnosis.
Over a period of weeks to as much as a year or more, the immune system will continue to attack the pancreas and kill off the remaining cells that are producing insulin.
As more insulin-producing cells die, the honeymoon period comes to an end.
Blood sugar levels during the honeymoon period
During the honeymoon period, a person with diabetes may experience normal or near-normal blood sugar readings while taking no or minimal insulin.
Normal blood sugar levels, or plasma blood glucose readings, for people with diabetes, are:
After fasting: 80–130 milligrams per deciliter (mg/dl)
1–2 hours after meals: Less than 180 mg/dl
Each person should speak to a doctor to find out their own target levels for blood sugar, as different people will have different needs.
During the honeymoon period, a person with diabetes may regularly see blood sugar readings within the healthy range while taking little or no prescribed insulin.
However, over time, they will notice fewer readings within the normal level, signaling that the remaining insulin-producing cells no longer function and the honeymoon period may be ending.
If a person uses more insulin than they need, blood sugar levels can fall. If levels drop below 70 mg/dl, this usually indicates low blood sugar, or hypoglycemia.
If this happens and the person feels faint or dizzy or experiences other symptoms, they should take a glucose tablet or another sweet item at once to raise their glucose levels. Hypoglycemia can quickly become a life-threatening emergency.
The person should speak to their doctor, as they may need to adjust their insulin intake.
If a person starts to experience increased thirst and urination, they should check their blood sugar levels, as these can be a sign of hyperglycemia, or high blood glucose levels.
If these are higher than the upper limit agreed with a doctor, the person should seek medical help, as they may need to adjust their insulin intake.
Diabetes management during the honeymoon period
Person with diabetes measuring their blood sugar levels.
A person will continue to take some insulin and monitor their glucose levels during the honeymoon period.
It is vital to work with a doctor to find the right amount of insulin during the honeymoon period
During this time, people should take some insulin, as doing so may preserve the remaining insulin-producing cells for longer. However, they need to monitor for levels that are outside the target range.
If levels are too high or too low, these can lead to hypoglycemia or hyperglycemia, both of which can have serious consequences.
Some doctors try to extend a person’s honeymoon period as long as possible, as blood sugar levels can be healthy during this time. When blood sugar levels are within the healthy range, there is less chance that they will lead to damage in other parts of the body.
A doctor may suggest dietary changes in addition to taking a certain amount of insulin.
Is a gluten-free diet a good idea?
Some research suggests that people with diabetes can extend their honeymoon period by following a gluten-free diet, but the individual should speak to their doctor about this.
People with celiac disease need to avoid gluten to stay healthy. Gluten is a protein that occurs in wheat and other cereals. It is present in a wide range of foods, including baked goods, packets soups, and some cosmetics.
Studies have shown that the chance of having celiac disease is significantly higher if a person has type 1 diabetes. As many as 1 in 6 people with type 1 diabetes may have it, compared with 1 in 141 in the general population in the United States.
A 2016 study looked at children with a new diagnosis of type 1 diabetes. Half of the children followed a gluten-free diet. Those that followed this diet had better blood sugar levels after 6 months than those who did not.
Find out more here about what to eat on a gluten-free diet.
What about supplements?
Another study found that taking vitamin D and omega-3 fatty acids supplements may help extend the honeymoon phase and better manage diabetes. Researchers gave vitamin D supplements to 19 people out of 38 with type 1 diabetes.
The 19 people that were taking the vitamin D supplements had a longer honeymoon period than those who took a placebo.
For now, the honeymoon period in type 1 diabetes is only temporary. In time, the remaining insulin-producing cells will die, and a person will need to depend on insulin treatments.
As yet, there is no cure for type 1 diabetes.
However, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), ongoing studies are actively looking at ways to:
identify type 1 diabetes early and prevent it from starting
preserve the function of the pancreas
improve monitoring, transplantation, and other techniques
delay the progression of the disease
prevent or reverse complications
One option they are considering is how to preserve beta-cell function in the pancreas, for example, by restoring normal immune function.
If scientists can do this, one day there might be a never-ending honeymoon period for people with type 1 diabetes.