The Effect of Insulin Glulisine Compared With Insulin Aspart on Breakfast Post Prandial Glucose Levels in Prepubertal Children

Inclusion Criteria: * current patient in the Helen DeVos Children's Hospital Diabetes Clinic; * ages 4-11 years; * prepubertal (Tanner Stage I); * diagnosed with type 1 diabetes mellitus with positive islet cell antibodies or presenting at time of diagnosis with positive serum or urine ketones and requiring insulin since diagnosis; * at least six months from date of diagnosis of type 1 diabetes mellitus; * TSH within reference range and negative transglutaminase IgA antibodies within nine months of study start; * HbA1C between 6.9 and 10% within 30 days of study start; parent or guardian able and willing to provide written informed consent prior to enrollment; * at time of study start, current insulin regimen includes multiple daily injections with insulin glargine as the basal insulin and insulin aspart or insulin lispro as the pre-meal rapid acting insulin Exclusion Criteria: * pubertal (Tanner stage 2 or greater); * concurrent Addison's disease, celiac disease or untreated hypothyroidism; - receiving oral, injectable or inhaled steroids or immunosuppressant medications; * receiving stimulants for treatment of attention deficit disorder or attention deficit hyperactivity disorder; * intercurrent illnesses such as a fever \> 101 degrees F, infection, or gastroenteritis; * use of any medication to treat diabetes other than those listed under in inclusion criteria; * potential for lack of compliance or any other issue which, in the opinion of the investigator, would compromise the subject's safety or successful participation in the study