Since the discovery of insulin, alleviation of the burden of insulin therapy has been a constant worry. In The Lancettoday, Roman Hovorka and colleagues report a milestone in the quest for an artificial pancreatic (3 cell that started almost 50 years ago. Restoration of missing beta-cell function by an automated, glucose-modulated, insulin-delivery system was initially supported by reports of glucose swings in patients treated with insulin injections, resulting in extreme cases of so-called brittle diabetes. The Diabetes Control and Complications Trial2 later underscored the need for sustained near-normal glucose concentrations to prevent long-term diabetes-related body damage. Although technology applied to insulin delivery and glucose monitoring for the past 20 years has allowed substantial improvements in glucose control, for patients with diabetes and their caregivers the quest for the artificial betacell has remained similar to that of the holy grail for King Arthur's knights.
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