OBJECTIVES: To assess the cost and metabolic outcomes in children with diabetes mellitus treatеd with CSII or with human insulin. METHODS: It is a cost-consequence analysis. Retrospectively were observed patients dossier and health care resources used during the period 1999 – 2012. The study sample included 34 children aged 3 to 18 years with type 1 diabetes. Seventeen of the children are using continuous subcutaneous insulin infusion (CSII) therapy and 17 using intensified dosage regime of human insulin. The duration of the disease, diabetic control, HbA1c deviation scores, height and weight were observed. Cost of pharmacotherapy, test strips were calculated and compared with the therapeutic outcomes in both studied groups. The average improvement of HbA (1c) after the CSII introduction was chosen as therapeutic outcome. RESULTS: Subcutaneous insulin infusion (CSII) systems are not a standard treatment for the Bulgarian children; they are of a limited usage and are not reimbursed. From the 34 children with diabetes type 1 observed 17 were on CSII (mean age 10 years, mean duration of diabetes - 7 years, average usage of CSII - 3 years). The test stripes costs 533 Euro/ year and their average cost according to the duration of the disease is 3779.45 Euro since diagnosis. The blood glucose monitoring system costs 20 Euro and for the duration of the disease - 4.96 Euro per patient per year. The CSII price is 3896 Euro and it costs 1292 euro per patient per year. The average improvement of HbA (1c) after the CSII introduction is 1.85. In the group treated while human insulin the average cost per children is 925 Euro and improvement of HbA (1c) human insulin is 0.28 for the same period. CONCLUSIONS: The treatment with CSII leads to significant improvement in glycemic control compared to the treatment with human insulin at the comparable costs.