Despite the landmark findings of the 1993 Diabetes Control and Complications Trial, demonstrating that frequent blood glucose (BG) monitoring and intensive insulin therapy were effective for improving hemoglobin A1c (HbA1c) levels and delaying the onset and progression of microvascular complications in type 1 diabetes,1 there has been a translational gap in the achievement of optimal glycemic outcomes more than 25 years later. The gene discussed is INS; the disease is type 1 diabetes mellitus.