My doctor suggested that I was "pre-diabetic" over ten years ago due to an abnormal glucose tolerance test. At that time I read up in order to know what might be in store.
At that time the thinking seemed to be that proper control of blood sugar levels would eliminate the symptoms.
Unfortunately, the study found that virtually all diabetics were "out of control", even those who were most diligent and disciplined. The problem seems to be that the high blood sugar levels which occur are almost symptomless. Too much insulin can cause immediate life-threatening effects. Too little can go undetected.
At the time of my reading, much hope was being expressed for insulin pumps, but at the time the dosage would still have to be set based on too infrequent measures of blood sugar and anticipation of meals. If the technology has advanced since then so that the pumps could be driven off of "real time" blood sugar monitoring, then I think that they might be quite effective.
Another problem I vaguely recall had to do with the fact that the insulin supplied for diabetics might have effects other than what one's own insulin would have. Perhaps this was related to how the insulin was created, whether from scratch in a factory, or harvested from animals. I don't know what the state of that is now.
I have copied Freeper toast, who works at a company which makes insulin pumps for possible updates on the "state-of-the-art".
I actually work for another division but here is a link for the current "state-of-the-art" insulin pump and continuous monitor.
http://www.minimed.com/professionals/realtime/index.html
a company has developed an implantable chip which constantly measures glucose levels and can be red via a scanner type device. This will help in monitoring levels for those who do not like to stick themselves 4,5,6 times a day