AbstractIntensive insulin therapy was studied in six children with type 1 diabetes mellitus which was refractory to conventional insulin treatment. The methods used were continuous subcutaneous insulin infusion with a portable pump, and pre‐meal pulse infusion of short‐acting insulin with a pen‐type syringe supplemented with a bolus of long‐acting insulin. The former method was used in three patients for two weeks and in one patient for four months, in hospital, and the latter was used in two patients, starting in hospital and continuing for one year at home. Both these methods achieved better metabolic control than conventional therapy. In addition, insulin requirements decreased with continuous subcutaneous infusion but it had to be discontinued after discharge because of costs and the complexity of the equipment. With pre‐meal pulse infusion, insulin requirements increased compared with conventiona