The timely series of state-of-the-art reviews contained within this supplement provide a valuable overview of the current state of diabetes care, and the pharmacological interventions we have available. Our experts agree that one of the most important lessons to emerge recently concerns the magnitude of the malign influence on clinical outcomes of the cardiovascular risk factors associated with the dysmetabolic (insulin resistance) syndrome. Metformin is unique in being not only as effective as any other oral antidiabetic therapy in controlling blood glucose, but also having an unparalleled clinical database relating to improved clinical outcomes in pre-diabetic subjects, and patients with established type 2 diabetes.