Type 1 diabetes honeymoon phase: what it is and how long it lasts

Type 1 diabetes happens when the immune system destroys the insulin-producing beta cells in the pancreas. Breakthrough T1D UK explains that this is a slow process, which means people with type 1 can still have some functioning beta cells for some time after their diagnosis. These surviving cells continue to make some insulin, which can make type 1 easier to manage at first. That window is called the honeymoon phase or period.

The charity says you may need less insulin during this time and experience more stable blood glucose levels. It is not a cure and it does not mean the condition has gone. Diabetes UK is clear that there is currently no cure for type 1 diabetes and that insulin is the main treatment.

The numbers it gives help to explain the idea: by the time of diagnosis the immune system has typically destroyed 60 to 80 per cent of beta cells, you can have 30 to 40 per cent without needing insulin treatment, and people in the honeymoon period have roughly 5 per cent remaining.

Breakthrough T1D says not everyone with type 1 will have a honeymoon period and that it only happens just after diagnosis. People with a bigger pancreas are more likely to experience one because the same percentage destruction leaves more individual beta cells than in someone with a smaller pancreas, which it says means people diagnosed when they are older than six years of age.

It says people in the honeymoon phase are earlier in their type 1 diabetes development than others, because the immune attack often starts years or decades before diagnosis, as shown by screening projects that find people in the earliest stages before symptoms develop.

The charity says the honeymoon period lasts different lengths of time in different people, but it is always temporary, commonly a few months to a year, and for some a few years. It adds that eventually the immune attack will destroy most of the beta cells.

It mentions that some research studies have found that taking vitamin D3 and trying to keep glucose levels as stable as possible can help prolong the honeymoon period, and that people who have been recently diagnosed may be able to join clinical trials that aim to extend it. These are research findings rather than standard NHS treatment, and decisions about vitamins or trials should be discussed with the diabetes team.

Breakthrough T1D says that when the honeymoon period ends you may need to start taking more insulin and may find it more difficult to manage blood glucose levels. If you are finding this harder, it advises speaking to your diabetes team, who may have suggestions to make managing type 1 easier.

This is not a sign that you have done something wrong. The change is the underlying condition progressing as expected. It is a good time to review insulin doses, technology and support with the team, using the courses and regular reviews that NHS care provides.

The NHS says that when you are first diagnosed you will be treated in hospital by a specialist diabetes team, who show you how to manage the condition at home. Treatment is insulin to manage blood glucose, with a care plan covering carbohydrate counting, the type of insulin and timing, how and when to check blood glucose, HbA1c reviews 2 to 4 times a year, recognising and treating hypos and hypers, and advice on diet, alcohol, driving, exercise and sick day rules.

It says you should be offered a free group course within one year of diagnosis, such as DAFNE or the online BERTIE course, and that people with type 1 are entitled to free prescriptions. Insulin doses may need adjusting during the honeymoon phase, so doses should be changed with the diabetes team rather than guessed.

The NHS describes the main symptoms of type 1 diabetes as peeing more than usual, feeling very thirsty, feeling very tired and losing weight without trying, remembered as the 4 Ts: toilet, thirsty, tired, thinner. If it is not treated it can lead to diabetic ketoacidosis.

The NHS says to call 999 or go to A&E if someone has been peeing more, feeling very thirsty and tired and symptoms are getting worse quickly, or they have stomach pain, diarrhoea or sickness, feel sleepy or confused, or are breathing faster and more deeply than usual, as these could be signs of diabetic ketoacidosis. Having a honeymoon phase does not remove this risk.