Supplementary Material for: ISPAD Clinical Practice Consensus Guidelines 2024: Insulin and adjunctive treatments in children and adolescents with diabetes

1.WHAT IS NEW OR DIFFERENT
•Updated insulin treatment sections including new bolus and basal insulin formulations
•Updated recommendations on principles of intensive insulin treatment regimens including more intensive form of multiple daily injections with new generation faster acting insulins and ultra-long acting insulins, to achieve a high level of treatment personalization, better glycemia and empowerment for people with diabetes
•Review of the roles and rationales for new insulin analogs, biosimilars, and diabetes technology devices for insulin therapy in pediatric diabetology
•Summary of adjunctive medications used alongside insulin treatment that includes details on pramlintide, metformin, GLP-1 Receptor Agonists (GLP-1RA) and SGLT inhibitors.
•Key considerations with regards to access to insulin and affordability specifically innovative, multi-faceted approaches involving governments, healthcare providers, pharmaceutical companies, and advocacy groups to ensure that all persons with diabetes who need insulin can obtain it without financial hardship.