"It is no surprise that the 'new' insulins have failed to improve glucose control in most patients. Managing type 1 diabetes is, like becoming a champion golfer, a complex task in which coaching and perseverence are essential. Giving the amateur the most expensive set of clubs will not make him a champion golfer in the same way that changing a diabetic teenager with an HbA1c of 12% to analogue human insulins will not result in the target of 7% being miraculously reached. On the other hand, the expert golfer or expert type 1 diabetic may obtain a small but worthwhile advantage from a change of clubs or insulin. If no advantage results from the change, the golfer will revert to his old clubs but the type 1 diabetic has to be extremely determined to persuade the clinic to switch him back to his old insulin."