It's going to happen. It might happen quickly, but more often it's a slow realization: The diabetes honeymoon is over. How long it takes to get to that point is part chance, but how you react to it is all skill. Handling this time with both emotional and technical skills is a challenge, but one you must face.

Timing

Honeymoons can last from a month to as long as a year and a half. Some doctors claim to have seen rare cases that lasted as long as three years. One Boston physician tells of a patient whose honeymoon lasted a full six years. On average, though, if your child experiences a honeymoon, expect it to last from six months to a year at best.

As time goes by and you settle in, you'll begin to notice more spikes in blood sugars and/or a need for more insulin to cover carbs. You'll look at your week's logbook and begin to see trends. Usually lunch and dinner are the first times to show spikes in blood sugars, but each child is different. As you see these trends and talk to your team about upping doses, the realization will begin to set in for you, your child, and your team that the honeymoon is ending.

Timing of the honeymoon's end can sometimes be complicated by timing in life. For instance, most children's insulin needs go up when school starts (there is more downtime and less outdoor frolicking). You may think that the honeymoon is ending when it's actually just a normal life-adjustment time that you'll come to expect every year.

Parents can see why, during the honeymoon and just after, it is particularly important to be meticulous about keeping records. The only way you and your team are going to be able to make smart decisions on dose changes will be by studying your logbooks. Keep them and keep them well, so that the transition can go relatively well for your child's physical well-being.

Accepting the End

Parents and caregivers, even more than children, have a hard time accepting the end of the honeymoon and the beginning of the rest of diabetes. First, parents who were sure they could master diabetes to the point of practically nondiabetic averages find out that in fact, nature can be a bear when it comes to blood sugars. If you feel let down, talk to someone, either in your support group or on your health team. She'll tell you that you are not alone; more than one parent has been fooled by a nice honeymoon. She'll also remind you of how well you used that honeymoon time and how much you've learned.

It can also be difficult to accept that you're going to have to deal with some erratic blood sugars from time to time. Soon, gone will be the days when your heart nearly stops at a 300. Yes, you'll still react quickly and treat it as it should be treated, but in the end, you'll remember that diabetes is a marathon, not a sprint. Some miles you're going to stall a bit on; others you'll fly through. Honeymoon or not, it's all about the finish line. With your child, you are doing all you can to find the pace that makes the run a pleasant and healthful one for both of you.