At the completion of adolescence and secondary education thought must be given toward transition of patients to adult diabetes care services. This should coincide with an increasing degree of autonomy in self-care by the young adult in question. There are numerous challenges that may coincide with this period in a young adult’s life. Amongst other things these include moving away from home, living independently, mental health issues and changing medical teams. The last of these is further complicated by varying philosophies of care by paediatric and adult diabetes care teams. Adult diabetes clinics may be busier less pastoral in their approach than paediatric diabetes clinics. Diabetologists treating adult patients assume that patients are wholly responsible for their own lifestyle decisions and actions and that the clinician’s role is simply to provide advice and encouragement. This is a critical time in the diabetes care of young people underscored by the fact that this is the period of greatest risk of sudden death. Despite this there remains no evidence-based “best model of care” for transition clinics to date. In practice adolescents should be made aware of the different adult clinics available and the different practice-style of those clinics. In some centres, specific young adults’ clinics are provided. The purpose of such clinics is an attempt to ensure successful transition. Unfortunately though, the issue of successful transition from a pediatric/adolescent clinic to an adult program remains problematic for many. Many clinics experience large drop-out rates during the process of transition despite transition workshops and active collaboration with other adult diabetes services. If transition is not successful and patients are lost to ongoing specialist care, diabetes control usually deteriorates markedly, maladaptive lifestyle practices become entrenched and the early appearance of diabetes-related complications frequently results. Frequently paediatric diabetologists have been involved in their patient’s care for many years and the thought of transition may understandably be greeted with concern by both adolescents and parents. Paediatric diabetologists then have a critical role to play in preparing their adolescent patients for the transition process.