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Question:

From San Francisco Bay Area:

Unfortunately, doctors still commonly take Type 1 diabetics off of insulin during the honeymoon period. I and many other Type 1 diabetics that I know who were diagnosed as "young adults" (I love it that we're "young adults" up to age 40!) were taken off of insulin following initial lowering of high blood sugars (in my case, 619 mg/dl) and put on pills for Type 2 diabetes.

(My information: Female, diagnosed with Type 1 diabetes 2+ years ago at age 35, normal weight although I have low body fat (15%) due to genetics and the fact that I'm fit; hospitalized at diagnosis and put on insulin drip, taken off of insulin, released from the hospital with a prescription for glyburide [a sulfonylurea diabetes pill]. One week later, at my insistence, my endocrinologist put me on insulin. I am now well controlled on 4 injections per day (Humalog and NPH)).

Answer:

You are quite right when you remind us that many doctors probably still try to manage the honeymoon phase of Type 1 diabetes in "young adults" with pills, taking them off insulin as soon as the patients get better, with very little rationale!

Exogenous insulin by injection, even a very low dosage, exerts positive effects towards either the amount and the length of residual beta cell endogenous [internal] insulin secretion (during the honeymoon) and has positive effects on the autoimmune reaction which is destroying the beta cells. Pills, on the contrary, shorten the honeymoon phase. Last but not least, keeping patients on insulin, even at very low dosage, helps with maintaining their collaboration and compliance in future lifelong conventional intensified therapy and in preventing micro and macrovascular complications.

MS

Original posting 10 Aug 97

  
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Last Updated: Tuesday April 06, 2010 15:08:54
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