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The Hospital for Sick Children

For health-care professionals

This section is designed to assist Health Care Professionals in managing newly diagnosed Type 1 diabetes mellitus, and in managing its complications. The information contained in this Web site should be used as guidelines. For any emergency, please do not hesitate to contact your nearest paediatric diabetes centre.

Newly Diagnosed Diabetes

  • Diagnosis: random blood glucose > 11 mmol/L, glycosuria ± ketonuria
  • Symptoms: polyuria, polydypsia, polyphagia, weight loss, approximately 25% of children present in diabetic ketoacidosis

Management of New Stable Diabetic (No DKA)

  • Admission to hospital indicated only to correct ketoacidosis or if other factors (distance, language, psychosocial) make ambulatory care difficult; stabilization and initiation of diabetes education for child and family can be achieved on outpatient basis


  • Initial daily insulin dose = 0.3-0.6 units/kg/day divided 2/3 pre-breakfast and 1/3 pre-supper
  • Each dose is divided 2/3 NPH insulin and 1/3 Lispro/Regular insulin
  • For children over 5 years, the nighttime dose can be split as Lispro/Regular insulin pre-supper and NPH at bedtime
  • Monitor blood glucose levels before meals, before bed, and at specific additional times as indicated during period of adjustment
  • In younger age group and during initial diabetes education period, blood glucose levels should be kept between 6-12 mmol/L; once patient and family familiar with monitoring and treatment, optimal glucose target can be decreased to 4-8 mmol/L
  • Anticipate decrease in insulin requirements in first few weeks post-discharge with increased activity and honeymoon period
  • Comprehensive outpatient educational program and ongoing communication with diabetes team essential in long-term management of child with IDDM