This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite improvements in diabetes care and insulin therapy, patients with type 1 diabetes (TID) continue to have significant post-prandial blood glucose excursions. These periods of hyperglycemia correlate with long-term complications associated with diabetes. Amylin, a natural neuroendocrine hormone secreted by the beta cell, improves glycemic control by regulating glucagon secretion and slowing gastric emptying. Replacement therapy is now FDA approved for adult patients with T1D in the form of pramlintide, a synthetic form of amylin. Amylin is not yet approved for use in adolescents under 16 years of age. We hypothesize this potential replacement therapy would be a useful adjunct in adolescent patients who are insulin resistant secondary to puberty and therefore at greater risk of post-prandial hyperglycemia. Our study proposes a 36-day trial investigating pramlintide effects in adolescent patients with sub-optimally controlled T1D.