Last Saturday, a diabetic child came in for a follow-up appointment, a girl, 8 years old, diagnosed with type 1 diabetes for more than 1.5 months and discharged from the hospital for 1 month. Since the child was fasting, I rushed to issue the usual labs and sent her for blood tests first. In the afternoon, the test results came out, and I talked with the parents while reading the test results, and I was shocked: the parents said that they had stopped the child’s insulin treatment a week after discharge, because a certain drug was prescribed through an acquaintance in a big brand hospital in Beijing, which was in the clinical trial stage, without a drug name, and when asked further, they had not signed the common informed consent form necessary for the use of drugs in clinical trials, without any hints and guarantees, and they were just The drug was taken orally. I asked the parents, then you feel comfortable, the answer said, monitoring the blood sugar are quite good, before the meal is generally 5-6, after the meal is rarely more than 6 points a few. I looked down at the labs with wide eyes and saw that insulin and C-peptide were normal, except for glycosylated hemoglobin 8.5 (reflecting the average blood sugar level in the past three months) which was slightly high, but the other indicators were really not abnormal. We talked with the parents again and advised them to continue to monitor their blood glucose and review it regularly. Looking at the parents’ expression of joy, I had a growing concern in my heart. Generally speaking, type 1 diabetes, also known as insulin-dependent diabetes, is the main type of diabetes in children, accounting for more than 95% of childhood diabetes, and is a chronic metabolic disease that starts in childhood, with hyperglycemia as the main biochemical feature. At present, insulin is still the most important drug for the treatment of type 1 diabetes. However, the regret of insulin treatment is that it must be injected subcutaneously. Many parents can ignore the financial cost, but prefer not to let their children “suffer”. It is based on this “loving and caring” original intention that some parents can ignore the harm caused by high blood sugar to their children and prefer to take Chinese medicine, stem cell transplants, and believe in certain prescriptions to try their own treatment of diabetes. This child is different, although she stopped the insulin application, although her monitored blood glucose is normal, but whether it is the medicine she is taking that is working, or whether she happens to be in the “honeymoon phase”, the thought pulls me back to the natural course of childhood diabetes. The process of childhood diabetes has a certain developmental pattern, which is usually referred to as the four phases, from the appearance of symptoms to the clinical diagnosis, is the acute metabolic disorder period, the children in this period are more serious, and even manifest severe ketoacidosis, need to be actively rescued, and eventually most children after insulin and diet adjustment treatment, clinical symptoms disappear, into remission. The remission phase, which is the focus of our discussion today, is a clinical remission phase (honeymoon phase) after 1-3 months of intensive insulin treatment for children with type 1 diabetes, when insulin needs are reduced. It is called partial remission when the daily insulin requirement is <0.5u/kg, and about 2/3 of children can be in partial remission for several weeks to more than a year, and there are few partial remissions in young children, and it is easy to see partial remission period with the growth of age until adolescence. About 2-3% of children can be in complete remission, that is, they can maintain normal blood glucose without insulin, which lasts from 1 month to 2 years. During the remission period, the function of pancreatic islets is partially restored and a certain amount of insulin can be secreted, so if the diet control and life arrangement are appropriate, the remission period can be prolonged. We have seen a child in remission for three years. After the remission period, all children will enter the intensive diabetes and permanent diabetes period. In the last stage, pancreatic islet function is completely destroyed and there is no endogenous insulin synthesis and secretion, which is irreversible and requires lifelong insulin treatment. After clearing the above ideas, so I thought, this child stopped insulin for 3 weeks, but the monitoring of blood sugar is normal, could be entering the honeymoon period (remission period), this period is important for the management of diet and life, but it is more important to closely monitor blood sugar and review regularly, so as to avoid delays in the treatment of the disease. On the other hand, all children and parents who have gone through the acute phase, I would like to remind you here that you must manage carefully and grasp the honeymoon period of each child so that they can minimize the harm of the disease to their body. The Spring Festival is approaching, which is a severe test for any child with diabetes. I worry if the children can control their mouths and their blood sugar, there is still a long road ahead, sugar babies, go!