Subcutaneous insulin has been used to treat diabetes since the discovery of insulin itself. However, despite a number of different formulations and routes of administration, intensive insulin therapy without limitations, such as too low bioavailability, has not enjoyed widespread clinical acceptance. Attempts to find effective, well-tolerated routes for delivering insulin began in the late 1920s and as of today, an ideal insulin delivery is still formidable. The most recent advances in insulin delivery are focused on using the inhalation route. The recent European filing of inhaled insulin (Exubera) is providing hope for alternative delivery routes, for example. This article reviews recent advances and approaches that hold promise toward the successful development of insulin delivery for the management of diabetes. Drug Dev.