Simon is a general paediatrician who started at King’s as a consultant in 2010. He has worked in children’s general paediatrics, endocrinology and diabetes all that time and has seen the huge changes that have happened in diabetes management, from fluids in DKA, through to carb counting, diabetes technology and soon immunomodulators. He will offer a personal reflection on some of the dilemmas in diabetes management for the generalist.