Non-pharmacologic treatment
Non-pharmacologic treatment such as use of dextrose free fluids and dietary management should be first thing to be considered as soon as the diagnosis of DIDM is entertained, unless patient is unstable and/or has metabolic derangements due to severe hyperglycemia. Dietary changes should focus on optimizing the amount and type of carbohydrates (avoid simple sugars and increase proportion of complex carbohydrates), taking care of the caloric needs of the child to maintain adequate weight during therapy. Challenges specific to ALL patients i.e., poor appetite, catabolic state, treatment induced gastritis/gastro esophagitis should be addressed whenever possible.