Optimal Control of Blood Glucose: The Diabetic Patient or the Machine?

In this issue of Science Translational Medicine, El-Khatib et al. describe a closed-loop bihormonal artificial pancreas, designed to avert episodes of low blood sugar in patients with insulin-dependent diabetes. We discuss the benefits and challenges of therapy directed at tight control of blood glucose and ask whether this and similar technological breakthroughs can address as yet unanswered questions in the biology of diabetes.