<p>The periprocedural period represents a critical time for children and adolescents with diabetes, during which they are at increased risk of complications. The management of diabetes in this context has become increasingly complex due to the wide range of available insulin regimens and glucose monitoring technologies. The <i>Australasian Periprocedural Guideline for Children and Adolescents with Diabetes Mellitus</i> has been co-developed by New Zealand Paediatric Endocrine Society, Australia and New Zealand Society for Paediatric Endocrinology and Diabetes, Society for Paediatric Anaesthesia in New Zealand and Australia, and consumer representatives. The guideline emphasises the importance of involving individuals with diabetes and their caregivers in the development of management plans, adopting a multidisciplinary approach when appropriate. It provides detailed guidance on procedure classifications, the perioperative use of existing continuous glucose monitors and insulin pumps, fasting protocols, perioperative intravenous fluid and insulin administration, and hypoglycaemia management strategies. By adhering to this guideline, healthcare providers can deliver safe, comprehensive, and patient-centred care throughout the periprocedural period.</p>