Since the 'Diabetes Complications and Control Trial' results were published in 1993, intensive insulin therapy has been the standard treatment for paediatric patients with insulin-dependent diabetes mellitus. This therapy significantly lowers the risk of long term complications of diabetes. The intensive therapy occurs by either continuous insulin infusion via a pump or a 4-times daily injection regime. In three young patients--two girls of 16 and a boy aged 12 years--the intensive treatment option appeared to be inadequate due to a variety of factors including lack of parental support and an eating disorder. All patients were put on a 2 or 3-times daily regime, which resulted in great improvements to their HbA1c levels and sense of well being. To the boy and one of the girls, extra support was given by a home care nurse. We recommend an individualized approach to the paediatric diabetic patient when it comes to the degree of intensity of the treatment.
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