Initiation of therapy in a life-long disease such as insulin-dependent (type I) diabetes mellitus (IDDM) represents a dramatic event for the child and his family. Epidemiologic surveys in the Netherlands over the past 15 years show a marked increase in the incidence of IDDM among children 0 to 19 years of age, contrasting with a reduction by more than 50% in all admission days for IDDM between 1980 and 1991. This reflects improved initial diagnosis by primary care physicians and improved self management by their families at home. Accordingly, out-patient initial management has been increasing. Given appropiate facilities, there is room for extension of non-admission for these children. The conditions for doing so are outlined in this article.