The number of children with diabetes is growing. Some countries, particularly in the developed world, are seeing a significant increase in the incidence of type 1 diabetes; type 2 diabetes in children and adolescents is an emerging problem worldwide. Premature deaths as a result of undiagnosed diabetes are a large and hidden global problem. Moreover, children with diabetes risk developing disabling and life-threatening complications at an early age, placing a significant human and economic burden on families and societies. Gyula Soltész reports on the changing trends in childhood diabetes and points to the ongoing impact of social and environmental factors in this emerging global epidemic.