Abstract
The distinction between the medical and the surgical approach to disease has been a cornerstone of medical practice, and indeed with respect to the business and technology of medicine. It is common knowledge that diabetes is a medical disease-namely that drug therapy, whether it be via insulin or other medications, is the primary approach to therapy. This article argues that a reevaluation of the generalized (e.g., medication-based) approach to systemic blood sugar control may be in order. A consideration of the growing importance of interventional, device-based, or other surgical approaches to the primary management of diabetes has enormous implications for clinical practice as well as, of course, the business and technology of diabetes care.