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Necmettin Erbakan University Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Konya/TURKEY Diabetes is a well known disease since ages. Its prevalence is increasing rapidly due to life style changes and eating behaviour for the last century. World Health Organisation announced Diabetes as ‘pandemic' which is the first chronic disease besides infectious ones. Despite all the cautions, diabetes frequency is still rising enormously. When chronic complications are taken into account, diabetes can be accepted as a vessel disease. Treatment reduces chronic and acute complications. Milestone of diabetes treatment is the discovery of insulin in 1921. Pathophysiology of diabetes is multifactorial and involves, insulin resistance, insulin deficiency, glucagon overproduction, GLP-1/GIP resistance-deficiency and cytokines relased from the adipose tissue. New therapies emerged and the newer ones are on the way. DPP-4 inhibitors, GLP-1 analogs, SGLT- 2 (Sodium Glucose Transporter-2) inhibitors and new analog insulins are the novel diabetes treatment therapies. Treatment goals are not at the target in most of the diabetes patients. It should be kept in mind that diabetes prevention and postponing the diabetes diagnosis are important as much as the treatment of hyperglycemia after the disease emergence. Keywords : Diabetes mellitus, treatment, insulin