Our hospital has recently begun performing paediatric lung transplants. Here we present two patients. Firstly a 12 year old girl from a rural area with new onset diabetes following lung transplant for veno-occlusive disease. The second a 14 year old girl with poorly controlled cystic fibrosis related diabetes predating her lung transplant.

The challenges of managing diabetes and educating patients in this comlpex setting will be discussed including: lack of success with premixed insulin in both cases; effects of anti-rejection medication; the significant psychological distress of the patients and their families; information overload.