Wednesday, November 30, 2005

When the Honeymoon Ends~

When is the honeymoon over? I've been scratching my head on this one.

For those of you who don't live in Type-1-Diabetes-Land, the "honeymoon" is a period after the initial diagnosis where the patient requires very small amounts of insulin, because his or her pancreas is still functioning to some extent. Eventually, though, all the beta cells (which produce insulin) in the pancreas are killed. And then the honeymoon is over.

Typically, insulin needs spike dramatically when the honeymoon ends. The disease becomes more difficult to control since any mistake will cause a huge fluctuation with blood sugar numbers, where previously, the pancreas's limited function could "cover" for a mistake. Yesterday Violet wrote a very interesting post about her own honeymoon ending. It got me thinking... Our son was diagnosed with diabetes on July 17, 2004, well over a year ago. Most honeymoons don't last past a year, but can you believe that I'm not even sure when his ended? Or IF his has ended?

My gut tells me his honeymoon ended about six months ago. It was a gradual process and one I really didn't notice all at once~and unlike most "honeymoon ending" stories, his insulin needs stayed pretty stable (although we had to increase his morning insulin to carb ratio).

There was one thing I did notice, though. The disease became very unforgiving. It used to be, I could give him a package of crackers (~15g carbohydrates) and his blood sugars would move maybe 10 points. Now, though, if I did that, his sugars would spike anywhere from 50 to 100 points, depending on his activity level. These days, I have to give insulin for everything, even the cough syrup he's taking today. (It's so nice to be able to bolus tiny amounts with the pump~his numbers are a lot better.)

So was this gradual experience the end of our son's honeymoon? Most stories I've been told have been that one day, BOOM. Insulin needs spike dramatically, honeymoon's over. In other words, the end is very obvious. But for him, it wasn't obvious.

Maybe the difference is that he was so sick at diagnosis. Maybe he didn't have that many beta cells left to begin with.

Not that it matters, exactly. But as Sandra said (her son Joseph seems to have come out of his honeymoon, too), it's sad to think about those last beta cells dying.

It's part of my baby dying, after all.