While both type 1 diabetes and type 2 diabetes can occur in children and adolescents, the overwhelming majority of people affected by diabetes worldwide are adults. Consequently, the specific needs of children are often overlooked. Type 1 diabetes, the most common chronic disease in children in developed countries, is growing by 5% among pre-school children and by 3% in children and adolescents each year – 70 000 new cases every year in children aged 14 years and younger worldwide. Thomas Danne and Olga Kordonouri describe the special and changing needs of young people with diabetes and call for these to be recognized and addressed.