The Centers for Disease Control and Prevention (2008) reports that approximately 0.2% of all persons under the age of 20 have been diagnosed with either type 1 or type 2 diabetes. This represents 186,300 children and young adults. Type 1 diabetes has traditionally been a disease of children and adolescents. Although type 2 diabetes has in the past been viewed as a disorder of older adults, in recent years, it has begun to emerge as a health-related problem among overweight children and adolescents as the prevalence of obesity has increased in this population. Since most children and adolescents (2-19 years of age) are likely to attend schools, the school setting has become an important venue to support and assist children as they manage both forms of this disease. This article presents a case report that exemplifies key issues on the management of type 1 diabetes in schools.