EDITORIAL TIME FOR ‘‘DRILLING DOWN’’

In the ongoing battle against diseases such as diabetes mellitus (DM), we seem to progress through distinct phases. With the discovery of insulin,1 the view of diabetes changed from one of lethality and suffering to hope and a ‘‘cure’’.2 Soon after, however, and into the middle 1970s, diabetes entered into a ‘‘chronic disease phase’ ’ with a sense of ‘‘inevitability’’ regarding devastating and deadly complications.2,3 The Na-tional Diabetes Act4 and the National Commission on Diabe-tes5 launched a 30 year phase of aggressive pursuit of greater understanding, discovery, and action, with A) emerging evi-dence of the size and scope of the diabetes burden;6 and B) convincing scientific efficacy evidence that both glucose con-trol mattered;7–9 and that macrovascular disease did not have to happen among persons with DM.10 The beginning of the 21st century heralded two additional phases: A) evidence that th