The epidemic of Type 2 Diabetes(DM2) that confronts the population of the US is well documented in scholarly publications and in the popular press. In the US, 7% of the population suffers from this disease. Diabetes prevalence increases with age; 20% of Americans >65yrs are affected. Diabetes disproportionately affects people of color, the poor, and those of low educational attainment. Obesity, lack of aerobic physical activity, and diet also make diabetes more likely to affect individuals. Type 1 Diabetes (formerly Juvenile Diabetes), is an autoimmune disease resulting in the destruction of pancreatic ?-cells and absolute insulin deficiency. DM2 (formerly Adult-onset Diabetes), is characterized by a cellular resistance to insulin's effect. Early during the disease course DM2 patients demonstrate elevated circulating insulin concentrations, but with time, an insulin secretory defect develops. DM2 accounts for 90-95% of Diabetic cases. Its prevalence is increasing and now affects adolescents, a previously rare event. Many with DM2 are asymptomatic; perhaps 1/3 patients are unaware that they are affected. Individuals with impaired fasting glucose or impaired glucose tolerance have come to be referred to as Pre-Diabetics; this also affects 7% of the population. Life-style change more effectively prevents progression to overt Diabetes than medication. Diabetes treatment prevents or delays the emergence of complications such as kidney failure, nerve disease and blindness. Important aspects of care target blood glucose, serum cholesterol, blood pressure, and aspirin treatment. Recently there have been new pharmaceutical targets harnessed in the service of controlling blood glucose. Current therapeutic approaches will be reviewed.