Table 5—

Insulin regimens for newly diagnosed diabetes after resolution of DKA

PrepubertalTDD 0.75–1.0 unit/kg
PubertalTDD 1.0–1.2 unit/kg
Before breakfastTwo-thirds of TDD
    • One-third rapid-acting insulin*
    • Two-thirds intermediate-acting insulin
Before dinner• One-third to one-half of the remainder of the TDD as rapid-acting insulin*
Before bedtime• One-half to two-thirds of the remainder of the TDD as intermediate-acting insulin
An alternative, basal-bolus method,
    consists of administering• One-half of the TDD as basal insulin (using insulin glargine)
AND
• One-half of the TDD as rapid-acting insulin; the dose before each meal comprises ∼15–20% of the TDD
  • *

    * In infants, toddlers, and preschool-age children, some clinicians use relatively smaller proportions of rapid-acting insulin before breakfast and dinner (e.g., one-quarter to one-third rather than one-third to one-half) and relatively larger amounts of intermediate-acting insulin. TDD, total daily dose.