Results from a number of recent studies highlight the importance of psycho-social factors in diabetes management. Research shows that psychological co-morbidity is prevalent in people with diabetes. As a result, well-being, self-care and glycaemic control are adversely affected. Depression is common in people with diabetes, and unfortunately under-diagnosed in many cases. Recent studies, including the Diabetes Attitudes, Wishes and Needs (DAWN) Study, indicate that in general, psychological support is under-resourced and inadequate in both adults and children with diabetes. In this article, Frank Snoek and Elize van Ballegooie present evidence that the growing appreciation of the psychological implications of diabetes has not yet translated into a significant improvement of psycho-social care for people with diabetes.