Type 1 diabetes is a complex long-term condition for which there is no cure. It can have significant consequences for patients, who need to adapt their lives to a demanding regimen of insulin therapy and will be at risk of various health complications, some of which are potentially fatal. A diagnosis of type 1 diabetes may come as a shock and may be challenging for the patient to accept, and when the condition is diagnosed in adolescence it is likely to compound the challenges many young people experience during this crucial developmental period. This article explores the effects of being diagnosed with type 1 diabetes in adolescence and describes the challenges involved in the management of this condition. It also outlines the role of the nurse in caring for and supporting adolescents with type 1 diabetes.