Childhood onset diabetes (Type 1 diabetes) is a chronic condition whose symptoms may be controlled using a careful regimen of diet and insulin therapy, which must be tailored to suit the sufferer's lifestyle. The ability of a child to cope with these aspects of diabetes management has a wide range of short-term and long-term implications. Medical treatment must clearly aim to maximise diabetic control and to minimise such negative outcomes. In order to do this, factors involved in optimising the coping process in children must be understood. While research has shown that managing children at home on diagnosis rather than admitting them to hospital, has no effect on diabetic control little research has been carried out into the possible psychological benefits of these two approaches (Howie, 1998). This study therefore compares the coping process in children who were admitted to hospital at diagnosis (in an Aberdeen clinic) and those who were managed at home (in a Dundee clinic). The Self-Regulation Model (Leventhal, Nerenz & Steele, 1984) was used to guide the study. This model highlights the role of parents' illness representations, coping, appraisal of coping and emotional reactions, each of which may be viewed within a developmental framework, in the progression of chronic disease. 70 children aged 7-14 attending diabetes outpatient clinics in Dundee (home-based management) and Aberdeen (hospital-based management) were assessed using standardised questionnaires of illness representations, coping, state anxiety and behaviour problems in children. The relationship between these variables and diabetic control and the effects of age, time since diagnosis and management at diagnosis on the process and outcome of coping were also assessed. The results are discussed in terms of their implications for management at diagnosis and for cognitive and behavioural methods of enhancing coping in children of different ages.