The honeymoon phase refers to the period following a diagnosis of type 1 diabetes in which the pancreas can still produce a significant amount of insulin.

Also known as the honeymoon period, the phrase is so called because this insulin production makes blood glucose control easier than it would be without the presence of insulin.

The honeymoon phase is temporary, and does not indicate that diabetes is in remission.

How long does the honeymoon phase last?

The honeymoon phase begins when a patient starts on insulin injections. This enables the pancreas to produce insulin from remaining beta cells, which will later be destroyed by the immune system.

This period typically lasts for between a few months up to over a year, although age of diagnosis can influence the length of the honeymoon phase.

Being diagnosed as an adult can lead to longer periods of insulin production, while a shorter honeymoon phase is usually experienced by children diagnosed under the age of five.

Sometimes, the honeymoon phase can appear to stop and start, but it ends when the pancreas stops producing sufficient insulin to aid control of blood glucose levels.

This can be defined as when HbA1c levels rise above six per cent (42 mmol/mol), but shouldn’t include an HbA1c test taken within three months of diagnosis – this is likely to be influenced by high blood glucose levels experienced prior to diagnosis. [1]

Insulin requirements

Insulin injections are still required during the honeymoon phase. These doses may need to be readjusted to find a balance between not taking too much, risking hypoglycemia, and taking too little, which could increase the risk of diabetic ketoacidosis.

It is essential to maintain communication with your diabetes team during this time in case your insulin doses need to be evaluated and/or altered.

How are blood glucose levels affected?

Blood glucose levels are generally easier to control during the honeymoon phase, and they may even return to normal levels.

Low blood glucose levels

There might be times in the honeymoon phase in which your blood sugar levels become persistently low. As a result, you may need to reduce your insulin doses to avoid hypoglycemia.

This should first be discussed with your health team, who can advise you on how to manage your insulin doses.

Can I make the honeymoon phase last longer?

Maintaining good control of blood glucose levels can extend the honeymoon phase, although this is not a guarantee. The honeymoon period can shorten, meanwhile, if your insulin levels fluctuate or you stop taking insulin altogether.

Diabetes management after the honeymoon phase

You may find that your blood glucose levels become harder to manage when the honeymoon phase comes to an end. Additional vigilance with blood testing will be required, as will more time being spent reviewing your test readings.

You will need to reassess your insulin levels with your diabetes team when the honeymoon phase ends.

Is it possible for the honeymoon phase to reoccur?

If you have lived with type 1 diabetes for a number of years and experience a phase of excellent blood glucose control, and reductions in insulin doses, you may assume that you are going through another honeymoon period.

It is unlikely that this is a reoccurrence of the honeymoon phase, though. In fact, it is more likely to be due to your body becoming more sensitive to insulin. This can happen following exercise, if you’ve recently adopted a new diet or been in a warm environment.

[1] http://www.ncbi.nlm.nih.gov/pubmed/16629716