Adolescents with insulin dependent diabetes mellitus (IDDM) who choose to be vegetarian have complex nutritional needs because of their continued physical growth and development, their participation in strenuous activities, and their need to consume sufficient carbohydrates to match their insulin doses. Since diet control is a cornerstone of diabetes management, the adolescent who chooses a vegetarian diet may cause their parents needless anxiety. Nurses working with these adolescents can provide support and guidance and liaison with the endocrinologist, nutritionist or dietitian, and diabetic educator. Although adolescent diabetic vegetarians have not been studied extensively as a population, facts about nutrition and diabetes can be used to assist in meal planning. A complete growth and nutritional assessment must be done to search for any problem areas. If protein dense flesh food is eliminated and a largely carbohydrate diet is consumed, there are additional areas of concern in regulating insulin needs. Blood glucose should be monitored very carefully during diet changes. Vegetarian girls with diabetes also should be carefully monitored for the adequacy of their diet because they may be at risk of developing an eating disorder.