Hi Elizabeth, I just wanted to add my encouragement along with everyone else's. I have lots I could say but essentially it all boils down to trying him on a pump. A couple of pages back someone kindly linked to the blog I wrote about my son. Although he is an extreme example and not really the best to base your son's care on, he does show that age, size, 'real estate', available fat or time since diagnosis are not reasons in themselves to deny a pump. The control we achieved with the pump, although far from ideal, was incomparable to anything we could have hoped to achieve by injections. The amounts of insulin my son required in the early days were tiny and often involved having him on the lowest basal and still having to turn the pump off for periods when he went too low. By three years old things were better but by no means stable. Young children have lower insulin requirements than older children so the swings you are seeing are not surprising. With my son's lack of a pancreas there was no honeymoon yet often his insulin requirement would be around the 0.5 IU/kg/day figure that was mentioned earlier in the thread. But your son's insulin sensitivity shouldn't be a reason for leaving sugars over 300 or 400 without correcting. If you need a pump to help, then you need a pump! Yeah, disagree with pretty much everything they are telling you. Pumps are not for everyone, I admit, but to deny access based on 'what ifs' is wrong when the evidence is so strongly in favour of their use in young children. The scientific literature on pumps and young children is sparse and much dates from a decade or so ago but what was clear even then was that pumps helped prevent the severe highs and lows, which is what you are experiencing, even if the overall benefit to glucose control was more sketchy. My son has pulled his site maybe two or three times in six years, and it has been pulled by accident a handful other times (once by an inquisitive preschool classmate and a couple of times getting in and out of car seats!). It's really not an issue. He never showed an interest in biting the pump, even through teething. He knows how to unlock it but knows not to, and we have never had an issue with him doing anything wrong with it, like bolusing by mistake (it's only us parents that have done that:redface. Absolutely correct. The idea that diabetes in young children can be treated by simple equations is ridiculous. Our diabetes team have always appreciated that but we have had bad experiences with other health professionals that assume they know the best way to treat him and ignored our advice to their (and our) regret. It seems that you knew the answer when you first posted here! I hope the respondents have helped reassure you. Good luck and if you have any questions about diabetes in preschool age children, just ask.