Aim: To determine whether a low dose of nicotinamide (NA) therapy for pediatric patients with type 1 diabetes, initiated within the first 24 h of diagnosis, prolongs the "honeymoon" period and lowers their insulin requirements. Methods: All children (n=66) with newly diagnosed type 1 diabetes admitted to Salmaniya Medical Complex between 1998 and 2000, received NA 1-2mg/kg per day, in addition to sc insulin bid. The patients were followed for 24 months (NA group). Findings in this group were compared with records from a similarly diagnosed control group (n=37), who were admitted to the same hospital between 1995 and 1997 and did not receive NA treatment. The insulin dose per kg bodyweight required at baseline and at 3-monthly intervals up to 2 years after diagnosis was determined. Results: At baseline, the two groups did not differ with respect to age, ethnic background, weight, insulin dose per kg bodyweight or glucose levels on admission. However, NA group had lower insulin requirements than control group at each 3-month interval up to 2 years after diagnosis. Conclusion: Our study results suggest that even low doses of oral NA given to children with newly diagnosed type 1 diabetes may reduce insulin requirements and prolong the "honeymoon" period.