The initial psychosocial impact of the diagnosis of insulin-dependent diabetes mellitus is evidenced by grief responses and crisis reactions. An overview of classic theories on grief and crisis intervention, as well as literature specific to diabetes, provides a basis for the development of appropriate nursing interventions for the pediatric diabetic client and family. The nurse, as a part of the health care team, can assess the psychosocial impact of the disease, and assist the family in the ongoing adaptation to life with diabetes. Emotional support, assistance with coping strategies and resources, patient education, tailoring of the treatment regimen, maintenance of hope, and close follow-up are essential nursing actions.