The science of diabetes is experiencing dramatic change and the implications for everyone affected by diabetes are enormous. We have good grounds for optimism and real expectations of a 'cure' for Type 1 diabetes in the longer term. This future would release us from the drudgery and risks of living with diabetes, and from the discrimination and social difficulties that go with it. Yet esoteric scientific advances are only part of the story. Each advance precedes the resulting improvements in treatment by many years, and in most parts of the world will seem irrelevant.