Many people think that diabetes care can only be delivered by a diabetes team. What is more important is the quality of the knowledge base of the members of the team, and the underlying philosophy of care.

The knowledge base, the experience of the team members, and the underlying philosophy of the clinic – whether it has a top down physician directed approach or a consultative partnership with the patient approach for example – will have a major impact on outcomes.

Diabetes teams make it more feasible to deliver quality care in a high volume environment, because the work can be spread out and responsibilities shared. They are essential in big teaching hospitals, because the high workload makes it difficult for any diabetes specialist, no matter how skilled, to deliver the full suite of services at a low cost to many people.

However, because patients are individuals, the wrong approach for a particular patient, seamlessly delivered and meticulously documented, will still not deliver good results.

And the best, most well informed team will be of no use to you if no one is willing to spend the time to listen to your concerns and actually understand what is going on with your child's diabetes.

Many people, including health care professionals, do not fully appreciate and take into account the difference between patients with Type 1 diabetes mellitus and those with Type 2 diabetes mellitus.

Another problem is that many people do not fully appreciate the vast differences between an adult and a growing child, and therefore do not take these differences into account when prescribing treatments and dietary and exercise advice.

The child with diabetes is not necessarily obese, and is expected to grow and develop just like a normal child of the same age and genetic background. However, obesity and features of the metabolic syndrome can coexist in a child with Type 1 diabetes. And common as well as rare diabetes complications do occur in childhood, so it is important to keep an eye out for these complications.

Research has shown that poor glucose control can impair learning, impair social interactions and academic performance. Therefore, the focus of our efforts should encompass strategies to ensure the best academic outcome for the patient.

Diabetes need not and should not be the reason why a child is not performing to the best of his or her ability in school and sports.

Newer methods of treating Type 1 diabetes mellitus involve intensifying efforts to achieve normal blood glucose levels while enjoying normal activities and as normal an eating pattern as possible.

These strategies usually involve multiple daily injections – also called the basal bolus method – and the use of insulin analogues, insulin pumps and continuous glucose monitoring methods.

The fine-­‐tuning of doses that insulin pumps allow has made many parents and patients wonder how they ever managed with just basal bolus injections. Similarly, continuous glucose monitoring gives essential insights into what is really going on with the person's blood sugar levels in the course of the day and helps the doctor and the patient make evidence-­‐based, effective and logical treatment decisions.

Even with insulin pumps, just buying an insulin pump and putting it on is only the start of the journey. Just as a good music teacher will help the student make beautiful music with a fine violin or piano, so a good partnership with a knowledgeable insulin pump physician will make all the difference whether you get good, fair or poor results with an insulin pump.

However, it is not the type of insulin or the number of injections per day which defines intensity of care, but the amount of thought that goes into designing doses which work for the patient whether at school or at play, at work or in competition. It is possible to achieve intensification of care with conventional insulins, it just takes more time and effort.