Stephen Clement, MD. introduces the listener to the "trade secrets " to successfully adjust insulin therapy for patients with type 1 diabetes. Insulin therapy has changed dramatically over the past ten years with the development of insulin analogs. The lecture discusses how insulin therapy as evolved from the standard insulin regimens of "Clear and Cloudy" insulins of the 80's to more sophisticated (and safer) regimens using new insulin analogs. Key research studies that mark each advance in therapy are cited. The listener is introduced to the concepts of carbohydrate counting, basal/bolus insulin therapy, insulin pump therapy, and how to adjust insulin for exercise and sickness. The author takes a look into the future of diabetes care with inhaled insulin and continuous insulin sensing.