Annals of the New York Academy of sciences – Currently, there are 382 million people living with diabetes mellitus around the world, and the total number is predicted to increase by over 50% over the next 20 years. Diabetes mellitus is a spectrum of metabolic disorders characterized by hyperglycemia. Poorly controlled diabetes mellitus can lead to microvascular and macrovascular complications, including kidney failure, blindness, amputation, and cardiovascular disease. Fortunately, medical advances have increased the number of treatment options for diabetes and improved outcomes for many individuals. However, there remains a need to determine the appropriate therapy for each individual, since a significant number of monotherapy treatments fail within 3 years and diabetes-related morbidity and mortality continue.