I have a few fundamental questions about diabetes and its treatment. 1. Are diabetes and hyperglycemia the same? If not, a) What is the difference? b) Our current treatment seems to be against hyperglycemia. What are we doing for diabetes? If both are same, a) What are the ill effects of higher glucose circulation? Do we have direct pathological evidence? b) Years on medication has not produced results. In short, are we merely treating the symptoms? c) Insulin seems to be our primary target in the treatment. Roles of glucagon, leptin, ghrelin, cortisol and many more are not targeted although they are also implicated in hyperglycemia. Are there any out of the box thinking in current research, with regard to such a serious, elusive and persistent problem for the past fifty years.