One hundred years ago, the use of insulin to treat type 1 diabetes mellitus in humans led to the survival of affected patients. While the diagnosis was previously linked to the certainty that the disease was immediately life-threatening, the use of the hormone insulin from 1922 on opened the prospect of positively influencing the course of the disease and thus improving the prognosis for the patients. The aim of this work is the analysis of 92,366 patients in a pediatric patient collective from Germany, Austria, Luxembourg, and Switzerland focusing on the use of the various types of insulin from 1995-2021. The proportion of insulin analogues has increased rapidly since 2000, also because the use of insulin pumps with analogue insulin compared to intensified insulin therapy via pen increased significantly for all age groups. In 2010, the use of insulin analogues in diabetes therapy in children was > 60%. In 2022, diabetologists have access to more than ten types of insulin and at least five different forms of therapy to treat type 1 diabetes mellitus.