World Diabetes Day (2008) brings messages of both hope and concern for children with or at risk for diabetes, for their parents and for the medical personnel who care for them. Good news for the international diabetes community emanates from the exciting advances in our knowledge of the genetics of type 1 (T1DM) and type 2 diabetes (T2DM) (1,2). Progress in our understanding of the molecular bases and pathophysiology of maturity onset diabetes of the young (MODY) (3) and neonatal diabetes (4,5) has allowed introduction of oral medications and freed many children from the discomfort and expense of insulin therapy (6), and the continuing development of new drugs and new technology for the treatment and monitoring of diabetes has added many valuable tools for our care of this disease. Counterbalancing these important advances is the evidence that the global burden of diabetes is burgeoning. The incidence of T1DM is increasing in many areas of the world and the prevalence of obesity and T2DM is spiraling to frightening numbers in nearly every industrialized and developing nation. The World Health Organization estimates that, between 2000 and 2030 the total population of the world will increase by 37 per cent while the number of people with diabetes will increase by 114 per cent (7).