If a child with diabetes develops ketoacidosis, it is absolutely critical that his or her parents are able to contact a trained healthcare provider immediately, 24 hours a day. Many parents report particular difficulties finding an experienced paediatrician to manage this emergency at night, and during week-ends and holidays. It has been demonstrated that these difficult situations can be overcome effectively using widely available telephone technology. A pilot project in this field, the Telephone Hotline Service, has been implemented at the Regional Centre for Children and Adolescents with Diabetes of the University Hospital of Parma, Italy. Through this service, parents have free 24-hour access to an experienced physician or nurse who guides them through the process of managing an episode of acute ketoacidosis. As a result, ketoacidosis has been prevented in a number of children and large admittance costs avoided.