Starting insulin in patients with Type 1 diabetes

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Some patients start treatment with twice-daily insulin injections using either a mixture containing premixed short and medium acting insulins twice daily or medium acting insulin alone; 8 units twice daily, 15 to 30 minutes before meals is a suitable initial dose for most patients; others will start with a three or four times daily regimen. Only those who are seriously weakened or ill need hospital admission and treatment either with intravenous insulin and fluids or multiple insulin injections. Many patients who present with acute diabetes enter partial remission soon after diagnosis, known as the "honeymoon" phase, when a small dose of almost any insulin is enough to maintain control. The practice of withdrawing insulin at this stage is not encouraged because after a few months the need for insulin is almost inevitable.

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