Our 9 yr old daughter was diagnosed with Type1 6 months back. My husband and I are both very involved in managing her diabetes, but we sometimes disagree on the approach. While he agrees with me (theoretically) that we need to avoid the lows more actively, he gets pretty upset at the occasional high. I've added an evening snack (2-2.5 hrs before dinner) in the last month+ to her routine, which sometimes causes a high just before dinnertime. He's really uncomfortable with this due to the long term implications of organ damage and so on, and wants me to cut down on this snack. I don't want to because: 1. The bg will remain high (170-250 range) only for a very short time - 30 min- 1 hour, because she soon gets the dinner rapid acting dose. 2. She was earlier getting lows about an hour after dinner. We couldn't fix this even though we played around with the insulin dose timing. This way I think she has less chances of getting the lows. 3. She's been looking a little thin and peaky of late, and the endo and dietitian are both comfortable with her eating more. 4. Anyway, she's going to have mismatches of insulin and sugars for short periods (because of not being on the pump, and general unpredictability). 5. her A1C improving and bg being in the 75-80% normal range most times, even after we introduced this snack Since I'm writing this post, I've obviously heavily weighted my side of the argument! But what I want to figure out is - isn't there almost always going to be some mismatch in the insulin/bg, and therefore should we worry about this one high so much, particularly if this is happening only 3-4 times a week or less? Please advise!! More details below for those with the patience to read through: We have a non-typical insulin regime for her because of long schooling hours, lack of trained staff to give her insulin at school (it's not mandatory in my part of the world, though her school's been incredibly supportive otherwise), relatively low insulin dosage, and non-availability of insulin which can be administered in fractional units. We know moving to the pump is the right answer, and we plan to do that over the next 6 months. These are her test numbers: A1C at dx 9.9 3 mths later 7.4 6 mths later 7.0 We currently test her 3-4 times a day, mostly before meals. 70-180 range considered normal. In normal weeks (when she's not down with a cold/fever, and we're in town, eaing most meals at home) we typically find about 75-80%of her readings in the normal range. Of the non-normal readings, about 5 will be high, usually sub 250. 1-2 lows. She's not on the pump yet, and currently on 5 units of a 70:30 mix in the morning, 2 rapid-acting at dinnertime and 2 long acting at bedtime. Also, if she's high after her evening snack (for which we haven't been giving her a bolus till now) he will play/make her play for a long time to get her sugars down. She's also tended to be very tired perhaps because of the long playtime after a long day at school.