My three year old son, who is teated with Lantus and Humalog, is in tight control (A1c: 5.8- 6.5%), but, unfortunately I need to test him 10 to 12 times per day to maintain this control. Why do we continue to see new invasive meters out on the market every six months? Other than the GlucoWatch, they have nothing to offer. I feel the only true way to obtain tight control is by keeping an eye on the sugar. I do have the watch for my son. and when he will keep it on for me it is wonderful and so easy to keep great control? How much longer until we see a better way of keeping control?

You have certainly done an outstanding job over blood glucose control in your young son, but the level of monitoring is likely to be hard to sustain. To begin with, I think that you should explore the possibility that you can get as good or almost as good hemoglobin A1c levels by limiting blood testing to before meals and bedtime with scattered additional tests in relation to activity, to changes in appetite as well as two hours after a meal. I am assuming also that you give the Humalog just after the meal so that you can adjust the dose to the pre-meal blood sugar level as well as to the number of carbs consumed.

Whilst the GlucoWatch has been an important advance it still, as you have found, has some disadvantages because of the long equilibration period and the difficulties, especially in small children, of maintaining calibration. The alternatives are making progress but not there yet. The Sugartrac is a non- invasive infrared based device which has not yet been tested in children. There are at least two groups who are conducting clinical trials with long-acting implanted glucose sensors presently linked to monitors, but with the hope that they will prove safe and reliable enough to be connected directly to an insulin pump. In the intermediary group, there are a number of variably sophisticated devices which measure blood sugars essentially painlessly on very small forearm samples. See Alternate Site Testing.

DOB