Drug therapy options for the treatment of diabetes continue to increase. But some of the most exciting developments in diabetes care are related not to drugs, but to the built environment and the clinic visit itself. I'll discuss the American Diabetes Association's revised Standards of Care that newly emphasize choices of drugs to specifically promote heart health. From there, I'll move to a discussion of changes to the structure of the clinic visit itself, incorporating strategies such as team-based care and remote monitoring. Finally, I'll discuss the evidence to support strategies in urban planning to prevent diabetes.