Starting insulin therapy in children with newly diagnosed diabetes.

Eight years ago, a decision was made to eliminate unnecessary hospitalization of children with newly diagnosed diabetes mellitus. This decision required changes in the basic approach to starting insulin therapy and education of the parents. Since then, 52 children aged 11 months to 16 years have been treated. Forty-four of these children were sent home after one to four hours of instruction. Five children received intravenous therapy for two to five hours and then went home. The remaining three children were admitted to the hospital for 18 to 40 hours. Subsequent establishment, at home, of diabetes control was accomplished without incident. The first injection of subcutaneous insulin was generally a combination of regular and slowly absorbed insulin. This approach has been well received by patients, parents, and referring physicians.