I agree with you about the negative effects of a large amount of insulin. I cringe every single time I read "they need what they need." Seems to be a common refrain but there is no reason a kid with type 1 can't develop insulin resistance and there is a greater prevalence of being overweight among kids with type 1. There is a reason that the "normal" amount of insulin is considered to be .5-1 unit/kg and an endo who does not address a child using a significantly greater amount of insulin is not doing his/her job, in my opinion. Especially when there are so many effective meds available to treat insulin resistance. The chart in this article is dramatic and really underscores the importance of addressing the potential for weight gain in type 1. I use symlin as well and I love it I have never had weight issues but I do think as I get older it will help minimize weight gain. I use a rather low dose of insulin (around .4 units/kg) and I do think that makes my blood sugars smoother. Feel free to PM me if you have any specific questions about using symlin.