The prevalence in Europe of insulin dependent (type 1) diabetes in children by age 15 is about 3 per 1000 and rising at roughly 2-5 % yearly.1 This complex and chronic illness interferes with almost every aspect of day to day life and can be a considerable burden for the child and the family. Therapeutic goals include “promotion of optimal health, social wellbeing and quality of life for all diabetic children around the world.”2

Living with diabetes entails continuous daily attention to a complex array of management options, including insulin administration and dose adjustments around variable meals and exercise, blood glucose monitoring and its interpretation, maintaining a healthy diet, and understanding the need for early detection of both acute and long term complications. This is daunting for many young people. In this week's BMJ Winkley …