A survey of district facilities and staffing for diabetes care in the South East Thames Region of England (population 3.58 million) is reported, and compared with the recommendations of the Royal College of Physicians and British Diabetic Association. Hospital Activity Analysis for diabetic patients in the Region for the year 1985 is also reported and costs assessed. Compared with recommended staffing levels there was a deficit of 12.8 Consultant Physicians with a weekly deficit of 109 sessions, and of 49.6 whole time equivalent Specialist Nurses. There were 11,857 admissions of diabetic patients, 4185 with diabetes as a primary cause. Seventy-six per cent of these were for diabetes without mention of complications and were therefore theoretically and potentially preventable. Total cost of diabetes care was estimated to be pounds 21.6 million p.a. for the Region of pounds 1.44 million per District Health Authority. We suggest it is time every Regional and District Health Authority gave some priority to diabetes care and established formal care strategies. To provide adequate staffing and facilities would improve standards of care, reduce morbidity and hospital admission rates, and be cost effective.