The use of insulin in the treatment of juvenile onset diabetes. General principles.

Insulin is a major tool in the treatment of juvenile onset diabetes in spite of the impossibility of giving it in a physiological way. Dosage must be individualized with the help of mixing short- and longacting types of non-immunogenic insulin preparations. Procedures vary with the stage of the disease, whether at the onset of diabetes, during the remission period or thereafter. Rapid normalization of blood and urine sugar is recommended in the first stage, which may partly preserve beta cell function. After the first two years of diabetes practically all patients require insulin twice daily. To achieve satisfactory metabolic control in diabetic teenagers is difficult and requires an experienced team of paediatricians, nurses, dietitians, psychologists and teachers, as well as informed, motivated and cooperative patients.