Insulin Therapy:
Insulin is the treatment of choice for DIDM secondary to glucocorticoids
and L-asparaginase(29)(36). It is suggested to begin insulin therapy
once diagnosis of DIDM is entertained. Table-2 (supplementary file)
enlists different types of insulin, onset, peak and duration of action
after subcutaneous injection. Children presenting with or developing DKA
should be managed with the existing standard guidelines for acute
management with intravenous fluids and insulin infusion(41). It is
prudent to document pattern of hyperglycaemia and tailor made the
therapy. Insulin regimen, dose, and duration should be guided by pattern
of hyperglycaemia, child’s age and the severity of metabolic
derangements.