The management of insulin-dependent diabetes mellitus is a challenge for the adolescent patient, his/her family and the health-care team supporting them. If treatment is to be successful and the longer-term complications of diabetes averted or delayed, nurses need to understand the various psychological and physiological factors that contribute to the difficulties in maintaining glycaemic control during this life stage. This article examines some of these factors with a view to encouraging nurses to adopt strategies that will improve patient confidence and coping skills in diabetic care.