Insulin treatment of newly-presenting ketotic diabetic patients into the honeymoon period.

Newly-presenting, ketotic juvenile-onset diabetics initially need full insulin replacement, and this has been attempted with ultralente insulin, including a loading dose, to provide the basal insulin requirement, and twice-daily soluble insulin to cover main meals. A simple method has been developed for the patient to reduce the basal and meal-related insulin doses during the stabilisation period, during which insulin production recovers and administered insulin needs fall. The method was applied to 12 patients, whose mean insulin dose was reduced over 4 weeks, from 62 to 33 units/day, with maintenance of good control.