Whereas insulin treatment of type 1 diabetes formerly was limited by the availability of one or a few types of insulin with suboptimal pharmacokinetic properties, insulin analogues with more fitting physiological action profiles have now been developed and ultimately near-physiological insulin treatment can be delivered with insulin pumps. Adjustments of insulin dosing can be rationally based on dosing algorithms. This requires frequent glucose measurements and knowledge about dietary carbohydrate content. Today, the treatment and its complexity are individualized according to needs and wishes of the patient.