Abstract
Perfect control of blood glucose levels in diabetic patients might ultimately be achieved with islet or pancreas transplants or with an artificial pancreas. However, to achieve such a goal on a large scale, it will be necessary to overcome the formidable safety or efficacy issues attendant with these approaches (see, e.g., [1, 2]). Meanwhile, in a substantial fraction of the estimated sixty million diabetic patients worldwide, current hypoglycemic therapy provides control of blood sugar levels that, in the long term, is inadequate. That is, current hypoglycemic therapy is still associated with substantial morbidity and mortality from the late microvascular complications of diabetes, principally diabetic neuropathy, retinopathy, and nephropathy. Attempts to achieve better long-term control of blood glucose through aggressive use of insulin and oral hypoglycemic agents, while yielding encouraging results, unfortunately have led to increased incidences of dangerous episodes of severe hypoglycemia.
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