There is no really straightforward or simple formula that can be adopted to treat a child with diabetes mellitus (> 99 % of children with diabetes mellitus have type 1 diabetes). Definitely, a patient with type 1 diabetes mellitus who has overt hyperglycemia and glycosuria must be treated with insulin. Insulin acts directly to counteract the metabolic defects of insulin deficiency. Additionally, there is now evidence that early, aggressive treatment with insulin may have a beneficial effect on progression to total insulin deficiency in type 1 diabetes by decreasing islet cell antigenicity and autoimmune destruction of b cells (1). For this reason, although temporary use of an oral hypoglycemic agent is possible in the early stages of type 1 diabetes, insulin is preferred.

It is pertinent to mention that newly diagnosed type 1 diabetics who receive insulin are at a greater risk of hypoglycemia and require small doses of insulin because some recovery of residual insulin secretion is possible. In the first few months of therapy, it is not unusual to see a decline, to very low levels, of the daily dose of insulin necessary for glycemic control, and in many cases, use of insulin could be stopped temporarily. This remission is often called "Honeymoon Phase" and may last for a few weeks to several months. During this period it is advisable to continue therapy with insulin at a low dose rather than stop it entirely, because intermittent use of insulin can increase it's antigenicity and as mentioned above, uninterrupted insulin therapy may have a beneficial effect in preserving b cell function.