Sorry I didn't notice this thread earlier. My son has just turned three so I thought I'd chip in. My first point would be to back up Lisa. DO NOT change your insulin regime without talking to your endo. A small change can make a huge difference in a toddler. I have huge respect for the likes of LantusFiend and Wilf: having read many of their posts over the last couple of years they are clearly intelligent, level-headed people with a lot to offer us newer members. But when it comes to toddlers proceed with caution on the insulin front. Secondly, relax. You're doing well. Your son's A1c of 9.1 is not too bad. It's not great but for a two year old not that long after diagnosis I wouldn't be too worried. At our last appointment we got an 8.3, down from the high 8s. How did we do this? We had lots of lows! A reduced A1c is not always a good thing! I've found that the A1c's quoted by people on this forum tend to be very good. This I think reflects the more proactive parents/PWD that are attracted to these forums. In the general type 1 diabetic population I think the average A1c is likely to be quite a bit higher than the average for those of us here. Also there is some suggestion that higher sugars in toddlers are not as harmful long-term as was thought. From your figures he is not staying high all the time but swinging around. While this is far from ideal and a nightmare for you trying to deal with, I think it would be far worse if he were staying high for long periods. It makes me really angry that you don't have the option of a pump. As an ex-pat Scot I'm ashamed that you are having to fight. You say you are rural. Is it just your local Trust that won't fund or is it across Scotland? If it is a small regional hospital do they have much experience with diabetics as young as this? Would it be worthwhile making contact with a senior endo at a larger institution and explain your situation. They may have more influence, or suggestions. As you suggest, a CGM would be great for you to get a handle on what he is doing. We have had a few goes with a CGM over the last couple of years, a week at a time, which has allowed us to tweak his regime, and also shown us we were pretty much on the right track anyway. The reassurance was great. One other thing. The highs during the night may be due to growth hormone. Possibly not but something to think about. A 2yo's main job is to grow and most of the growing will be done at night. The release of growth hormone can result in some temporary insulin resistance which could explain the highs. The last time we had a CGM we saw consistent spikes in BGLs about 2am. This was long after a feed so we think it may have been growth related. Unfortunately he can't tell us which nights he's going to be releasing the most growth hormone so we can't do much about them. The spikes come down afterwards. Unfortunately nighttime checks only give you a snapshot of what his BG is doing at that moment. A CGM would be wonderful.