My son was diagnosed type 1 less than two years ago when he was 15. I have not seen any questions regarding a child being very thin. He has grown at least 6 inches in the past year and doesn’t have an ounce of fat on him. He is 6 feet, 1 inch and weighs 140 pounds. The insulin is supposed to be injected subcutaneously, but we are noticing that the only sites we can use (back of the arm and back hip) are getting thick and the injections hurt him more now than a year ago. It also doesn’t seem to be working as well. He sees a family physician and he tells us to wait another year for a pump hoping that the technology keeps improving. What is your advise for skinny diabetics?

Without more details, such as the insulin regimen and the overall glycemic control your son is in, I have few specific comments.

My bias (here is a disclaimer) is that you have your son assessed by an endocrinologist or better yet, a pediatric endocrinologist. These professionals dedicate a good portion of their practices to diabetes only and, therefore, have the time and expertise and specialized staff to address issues such as this.

As for a pump, there is no reason a “skinny” diabetic could not use a pump; indeed, I think there are far more important considerations as to insulin pump use than the patients body fat composition!

Poor ability for a diabetic to gain weight has many possible explanations, including (but not limited to) sub-optimal glycemic control, concurrent conditions (e.g., hyperthyroidism, celiac disease, adrenal insufficiency), and others.

I hope this at least allows you to explore things more.

DS