Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) have clearly demonstrated that intensification of diabetes therapy reduces the risk of microvascular and possibly macrovascular complications in both type 1 and type 2 diabetes. 1–4 However, these studies also demonstrated how difficult it is for patients to achieve and sustain tight glycemic control over prolonged periods of time, even with insulin, the most powerful agent in our therapeutic armamentarium. 2–5 Moreover, both studies showed that intensification of therapy, especially with insulin, was accompanied by key clinical shortcomings, namely recurrent severe hypoglycemia and excessive weight gain. 3, 6–10 For many patients, these adverse effects of intensive insulin therapy represent the very obstacles that hinder the pursuit of optimal glycemic control. More recently, important advances in insulin therapy, including the refinement of insulin pump regimens for continuous subcutaneous insulin infusion (CSII) and the development of rapid-and long-acting insulin analogs, 11, 12 have offered new hope to both physicians and patients. However, despite the lessons of the DCCT and UKPDS and the improvements of insulin therapy, recent crosssectional data indicate that, in the general population with diabetes, levels of glycemic control are still far above the glycemic targets set forth by professional diabetes organizations (eg, the hemoglobin A1c [A1C] target of< 7% recommended by the American Diabetes Asso-