Initial Subcutaneous Insulin Requirement in Children With Newly Diagnosed Type 1 Diabetes

This study aimed to assess the factors affecting the daily subcutaneous insulin dose in children with newly diagnosed T1D. A retrospective file review of 85 children (≤18 years old) admitted to the hospital between 2020 and 2023 due to new onset T1D. Whereas total daily subcutaneous insulin dose (TDD) on the first day 1.3 ± 0.16 u/kg/day, it was 0.81 ± 0.28 u/kg/day on the last day. Total daily subcutaneous insulin dose on the first day was significantly higher in patients presenting with diabetic ketoacidosis (DKA) than in those presenting with ketosis and hyperglycemia (1.41 ± 0.14 u/kg/day and 1.19 ± 0.18 u/kg/day respectively). The three groups had similar TDD on the last day. The multiple linear regression analysis identified pH at admission and body weight as parameters affecting TDD. Our results support the high insulin requirement that continues after switching to subcutaneous treatment with the severity of acidosis. Therefore, subcutaneous insulin dose should be adjusted according to presentation characteristics.