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Fever, which is the regulation of body temperature at an elevated level, must be differentiated from hyperthermia. The pathogenesis of fever involves exogenous pyrogens acting on macrophages/monocytes to produce the endogenous pyrogen, interleukin-1, which acts on the thermoregulatory centre and also has important effects on the body's immune responses to infection. Fever by itself is rarely harmful, and there is no evidence that febrile seizures produce long-term sequelae. On the other hand, fever may be part of the body's innate protection against infection. The main reason for treating a fever in a child is to relieve discomfort. Acetaminophen should be the drug of first choice in treatment, and sponging, if used at all, should be employed only after acetaminophen has been given first. Education of parents about fever management can be helpful.

In order to manage diabetes mellitus in children, the physician must understand the principles of insulin action and dosage adjustment, meal planning, growth assessment, and the effects of exercise. The objectives of office supervision include ongoing education of the patient and family, excellent control of the diabetes, and the maintenance of normal growth and development, emotionally as well as physically.

A problem-solving approach is used to illustrate principles of managing diabetes mellitus in children. Situations discussed include adjustments for hypo- and hyperglycemia and vigorous activity, and care of the diabetic child who has another illness. The usefulness of referral to a diabetes education centre is emphasized.