Paediatric diabetes ranks among the most common chronic diseases in childhood and affects 23,000 children under 17 years in the UK with an increase at a rate of about 3% a year. Acute medical management at manifestation is well established and successfully conducted in the vast majority of cases. The chronic long-term treatment is challenging and involves self-managed, regular subcutaneous insulin administration for life, together with diet, exercise and lifestyle support to avoid short and long-term complications. Variability of average glycaemic control in children with type 1 diabetes exists between centres both nationally and internationally. Glycaemic control in UK children, however, is worse than in many other European countries. Herein, we review findings on glycaemic control reflected by glycated haemoglobin A1C and consider the current trend in the UK in comparison with the European continent. Furthermore, small practical differences in care delivery exemplified by differences in practice such as intensified insulin therapy and the use of insulin-to-carbohydrate ratios, differences in well established diabetes education and self-monitoring of blood glucose are discussed.
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