Basic and clinical research findings have led to an increased understanding about diabetes and its complications. Therapeutic approaches are now based not only on predicted effects from epidemiologic, correlative, or retrospective analyses, but often on prospective intervention trials comparing a new form of therapy to the standard methods. While this database may never be complete, partially due to the complexity and variability of the diabetic state, we now have excellent data that allow the development of aggressive new guidelines for care. Much of the material presented here reflects the views of the American Diabetes Association, as included in a recent publication (1). These guidelines are under review by a number of other organizations and will be subject to modification for special situations. Thus, the terminology "guidelines," rather than "standards of care," is chosen to indicate the flexibility necessary in developing such recommendations for general usage.