While hyperglycaemia per se has never been proven directly to cause a single one of the more grave complications of the disease, glycaemia is the only real yardstick to measure the adequacy of control of the disease. It is much in the same category as blood urea in the uremic state. Urea is presumably harmless. Unfortunately, the same cannot be said of hyperglycaemia. Persistent hyperglycaemia is destructive of the “endorgan” in carbohydrate metabolism. When one fails to recognize this principle, he is surrendering to the very pathology which it has been his challenge to correct. He may wishfully, if misgivingly, herald as satisfactory the nutritional state and sense of well-being of his patient; he has however, sacrificed every vestige of potential improvement in the patient’s own intrinsic insulin mechanism; he has often converted his patient into an irreversible diabetic with heavy and increasing insulin needs. Let it not be said that the medical attendant thru paths of lessened resistance has deliberately created this state of irretrievable failure.