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is there such a thing as being in remission?
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Question

My 17 year old son was diagnosed with type 1 diabetes two months ago. There is no family history, and his HbA1c at that time was 11.4%. For a few weeks, we titrated Levemir up to a dose of about 24 units, and then we added Humalog before meals.

Then I switched to a new endo because, even though our first one was good, I think, he didn't see any other teenagers, nor did they have a dietitian on staff. At our first visit with the new doctor (two weeks ago), he looked over my son's log, told us that he was in remission, and said it was the new term for the honeymoon phase. My son is just on Levemir at nighttime now and doing well.

This week I joined a listserv, introduced myself, etc. and received a reply that there is no such thing as being in remission with type 1. Should I just ignore that comment? Is there some validity to it? I want to make sure that our new endo knows what he is talking about!

Answers

Ignore the list serv. Remissions are classical in type 1, and the term is decades old. If your son is doing well on just one shot of Levemir, he is probably in remission. Hpwever, expect insulin requirements to increase in the future.

tgl     

I think there is an issue of semantics here. In other autoimmune-type disorders, sometimes "remission" is used. I do not use that term with type 1 diabetes. While a "honeymoon" may not be exact, it is rather descriptive and historically acceptable.

Your son likely is in his honeymoon of type 1 diabetes. All honeymoons end, and, in my experience, typically last 12-18 months. However, I have seen them as short as two weeks and as long as almost four years. It depends how well the patient (and the family) continue to watch meal planning, exercise, and insulin.

So "remission" / "honeymoon".....? "You say tomAYto, I say toMAHto; you say potAYto, I say poTAHto....."

ids     

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