No disease has had such an evolution of therapy in the past 80 years as type 1 diabetes. From certain death to the discovery of insulin, from impure animal insulin preparations to purified human insulins, from once daily long-acting insulin to CSII, from urine glucose testing to real-time continuous glucose sensors, treatments continue to emerge that improve the lives of people with type 1 diabetes. Our current challenges remain teaching the providers how to best use these new tools, directing our medical systems to allow us to best utilize these therapies, and perhaps most importantly, transferring these new technologies to the patients who can best apply them. Although the future is exciting, we need to first master the use of our current tools before we can successfully move forward. Hopefully, in the near future the successful management of type 1 diabetes will become a reality for all with this disease.