If you're lucky enough to experience the honeymoon phase after initial diagnosis of diabetes, it means you still have some beta cell function and your pancreas is producing insulin; not as much as a non-diabetic, but enough to enable you to cope with larger amounts of carbohydrate.
So what is the honeymoon phase and why is it so important to harness its power and try and hold onto it for as long as possible.
The symptoms of diabetes range from extreme thirst, fatigue, weight loss, frequent urination, excessive hunger and blurred vision. They occur because of a lack of insulin being produced by the pancreatic beta cells and increasing ketones in the blood. Essentially, the body is experiencing an auto-immune response, to what, we don't know. It begins to destroy the beta cells responsible for creating insulin.
However, in some diabetics who are caught early enough in diagnosis, they can continue to produce small amounts of insulin for months or even years. The insulin that is injected to help control blood sugars lessens the stress on the pancreas and this in-turn can help prolong the body's ability to create insulin on it's own.
"So what", you may ask. "The immune response has not been cured so i'm still on the path to a dead pancreas". This is not true.
Decreasing the stress on the pancreas, prolongs its ability to produce insulin. This gives the body the chance to repair and lessens the damage caused by oxidative stress, or the destruction of cells, proteins and DNA. Basically, this translates as reduced prevalence of long term complications.
But wait, there's more!
Studies have confirmed that by retaining a a degree of beta cell function (helping the pancreas to keep producing insulin) - after diagnosis is also associated with lower glycated hemoglobin A1c, and less hypoglycemia. Basically, your HbA1c is better and you experience less hypos.
So, this is all very positive, but how do I help my pancreas and stay in the honeymoon phase?
The best way to keep stress off your pancreas is to try and keep your blood sugars in range as much as possible, for as long as possible. We're talking strict glycemic control.
There's still some confusion to what constitutes 'in-range', so let's clear it up now.
3.5 mmol - 6.9 mmol
The reality is, if a non-diabetic is healthy, regularly exercises, and eats a healthy diet low in refined and processed carbohydrates, then they will VERY rarely go above 6.0 mmol. So, why are we saying 6.9? because we have diabetes and we will get sick, stressed, or consume a hidden sugar and our body doesn't have the insulin response to help us like a non-diabetic's would. We can still achieve fantastic blood sugars though, It just takes a bit more work.
How do I know when I'm in the honeymoon phase?
If you don't need rapid-acting insulin for food and your blood sugars are in range then you are still producing insulin. You will need basal (long-acting), as diabetes is progressive and even in cases where a person is diagnosed with LADA (latent autoimmune diabetes of adulthood) - characterised by increased levels of insulin being produced - they will still need to take basal insulin.
Many doctors will consider you in the honeymoon phase if you are still taking very small amounts of insulin. i.e. 5-10 units of basal per day. 1-2 units of rapid-acting per meal.
This may be true but if you are like me and follow a strict very low carb diet (VLCD) and exercise daily, this could mask the need for increased levels of insulin, and have the appearance of still being in the honeymoon phase.
I am 3 years since diagnosis and inject 6 units of basal and rarely inject more than 1.5 units of rapid-acting for a meal.
Get outside or into a gym and move your body. You don't have to run an ultramarathon or compete in an Ironman, but you need to move regularly.
One of the biggest factors impacting diabetics is the progressive damage of blood vessels due to high blood sugars. Exercise increases blood flow and helps the body repair itself. It also helps you manage your blood sugars better when eating, as the muscles feed on glucose and keep it from rising to dangerous levels in your blood.
Enjoying a long honeymoon phase comes hand-in-hand with regular exercise.
This can be a divisive subject as many people believe if you eat a balanced and nutritious diet then you don't need to add additional supplements. However, many of us are unknowingly following a diet that is missing key vitamins and minerals. A good example of this is fish. Many people do not enjoy fish but they contain a rich array of fats and oils proven to benefit our overall health, like omega 3 fatty acids, vitamin D and B2.
There have been studies that have looked at vitamin D and its impact on our sensitivity to insulin. There are also some scientists that believe it may help the production of insulin in the the pancreas. More strikingly, it is now known that raising your levels of vitamin D to above what is considered normal (60 - 80 ng/ml), can help keep blood glucose levels under control. Vitamin D3 also plays an important role in the body, including maintaining the health of your bones, teeth and joints. If you're deficient in this amazing vitamin it can lead to a weakened immune system and even depression. Talk to your doctor about testing your Vitamin D level and see how much supplementation will help you stay above normal levels.
Omega-3 fatty acids
A study from 2007 published in JAMA found that a diet rich in omega-3 fatty acids is connected to a reduced risk of islet-cell autoimmunity in children who were at an increased risk for type 1 diabetes. If you consume less than one or two portions of fish per week, it would be worth considering supplementing with fish oil tablets.
There has been a study of note in Denmark that saw a newly diagnosed type 1 diabetic child (who did not have celiac disease) adopt a gluten free diet soon after diagnosis. The child was in the honeymoon phase and 20 months after diagnosis the researchers suggested that a gluten free diet could help prolong the period, as they continued to consume a gluten free diet without rapid acting insulin.
More research has suggested that a gluten free diet can continue to support diabetics even after the honeymoon phase.
Take your Insulin
The number 1 factor that will support you in prolonging your honeymoon phase is keeping a strict insulin regimen. i.e. ensuring your body has enough to keep your blood sugars in range.
Be kind to your pancreas. synthetic insulin is amazing and has turned type 1 diabetes from a death sentence to a chronic disease that can be managed. But it is our responsibility to ensure we are as healthy as possible by eating the right foods, regularly exercising and being kind to our bodies.
If you or a loved one has diabetes and is experiencing a honeymoon phase, then it is very important you try, for as long as possible, to preserve it. Current standard predictions are that the honeymoon phase can last from a few weeks or months, and if you're still in it over a year then you're very lucky. The fact is, you don't have to be lucky, because you can take steps to prolong it and also lower your risk of reducing long term complications at the same time.
You can take a bit of the control back.
Believe the hypo