Diabetes is one of the most common chronic conditions in school-age children. In the USA, about 154 400 young people aged 20 years or younger have diabetes – about one in very 400 to 500. Type 1 diabetes accounts for about 80% of cases. In certain ethnic groups, however, the proportion of type 2 diabetes in young people is much higher. With the epidemic of overweight and obesity, healthcare professionals are finding increasing numbers of young people with risk factors for type 2 diabetes. Elizabeth Warren-Boulton reports on a school-based initiative to improve the management of diabetes among school-age children.