The changing face of health care and the widely variable needs of families have forced practitioners to change the traditional education approaches for pediatric patients with diabetes. Initial management and education for pediatric patients with newly diagnosed type 1 diabetes is now moving to the outpatient setting. The Diabetes Center for Children (DCC) at The Children's Hospital of Philadelphia has created an innovative program using a diabetes home care nurse as its coordinator. The role of the home care nurse is to manage and coordinate all of the diabetes education done by the field nurses in the Children's Hospital home care department. This program has enabled the DCC to manage and educate families during an initial 3-day inpatient stay, providing a safe transition to home. With follow-up by trained home care nurses, the families receive advanced education and support in their homes. The evolution of this program over the last several years has shown that patient care can be moved safely from a complete inpatient format to one that includes a large outpatient component.