The persistent need for insulin sensitizers and other disease-modifying anti-diabetic drugs.

Despite significant advances in diabetes care since the introductions of insulin and metformin, disease burden continues to grow. Large gaps in standard of care remain, and no robustly disease-modifying pharmacotherapy exists. Substantial research has been directed towards beta cell preservation and regeneration with no translational success, while little drug discovery or development is aimed at the other major cause of diabetes, namely, insulin resistance. Given the absence of convincing evidence that human beta cells can be regenerated, the diabetes community must broaden its focus to include new therapeutic strategies to limit, and reverse, insulin resistance.