With the recent report of the results of the Diabetes Control and Complications Trial, there can be little doubt that hyperglycemia is a major determinant of the long-term vascular complications of insulin-dependent diabetes mellitus. Better blood glucose control should become a primary goal for all diabetic patients However, successful and safe implementation of intensive diabetes therapy may not be possible for all diabetic patients. Hypoglycemia, regimen compliance, and availability of resources are the most significant remaining barriers to overcome before implementation of intensive diabetes therapy will be realistic for the majority of diabetic subjects.