In the United States 20.8 million people have diabetes. World wide the numbers of individuals affected by diabetes is staggering and exceeds 194 million people. Approximately 80% of diabetics have type 2 diabetes and 5-10% have type 1 diabetes.

Type 2 diabetes is generally associated with insulin resistance which can predate the development of hyperglycemia for years. Eventually the insulin producing cells of the pancreas (β-cells) are no longer able to keep up with the increased demand for insulin and hyperglycemia develops. Type 1 diabetes is due to absent or near absent insulin secretion that usually results from immunological mediated β-cell destruction. There are other causes of diabetes that are much less common and are due to a variety of genetic defects or secondary causes.

In 2002 the costs associated with the care of patients with diabetes in the U.S. was $92 billion. Much of this was due to complications of the disease such as eye, kidney and nerve damage. Diabetics, particularly those with type 2 diabetes, have a very high risk of developing cardiovascular disease due to associated metabolic abnormalities that include high blood pressure, high cholesterol and triglyceride levels. The past several years have witnessed significant gains in the management of diabetes, with therapeutics that have improved the care of patients. However most agents have modest efficacy and many patients require multiple agents to control their blood sugar and to treat associated abnormalities.