Almost every internist can treat diabetes, but to do so well requires a physician specializing in diabetes, that is, an internist with specialized training in diabetes, but to treat diabetes to the fine point, the specialized physicians also need to have a high level of nutrition theory and practice, considerable knowledge and practice of sports medicine. To date, diabetes is still a disease that can only be controlled but not cured, and it is not entirely accurate to say that it is a disease, but a combination of diseases, because it is not pure. How to understand diabetes is the key to proper understanding and reasonable treatment. Comprehensive current research on it by experts and scholars, diabetes can be understood as a syndrome characterized most by high blood sugar, while often combined with abnormal blood pressure and lipids, accompanied by a low degree of inflammatory response and a significantly poor lifestyle. Why treat diabetes is a key issue that must be fully understood by the patient. Significant polyuria, dry mouth, weight loss, or other discomfort may prompt you to seek medical attention, but not for those who have no significant symptoms, and this is where the importance of recognizing the importance of treatment becomes even more important. In a word, treatment at this time is to prevent complications from occurring, and since prevention means preventing sensation when there is none, it is hard to say what significant comfort will be experienced during treatment. The year was an unusual one for diabetes treatment, as there were many research results that provided a strong evidence-based medical basis for the rational treatment of diabetes. As a systemic project, the authors propose a new treatment concept: the “Big Five” + “Little Five” integrated treatment of diabetes. The Big Five includes: comprehensive control of blood glucose, blood pressure and lipids, aspirin use, and lifestyle modification (smoking cessation). The Little Five is the traditional concept of diet, exercise, blood glucose monitoring, diabetes education and medication. The former reflects the all-cause intervention of diabetes and the comprehensive protection of large blood vessels, while the latter reflects the control of blood glucose and the prevention and treatment of microvascular lesions. Only when the “five carriages” are used at the same time can the diabetes treatment plan be considered perfect and the treatment effect can be optimized. Emphasis on one point: smoking for diabetic patients, how to say that the great harm is not too much, mainly in the cause of some vasoconstrictive substances secretion, so that vasoconstriction, blood pressure increases, so that the blood viscosity increases, may directly induce vascular blockage, so that patients for all the treatment of diabetes to go up in smoke. So quitting smoking is not just a lifestyle improvement for diabetics, it is a real “cure.” In addition, the traditional five-horse cart concept of “diabetes education” is more appropriately understood by patients as “learning about diabetes” and “updating treatment concepts with the times. “This is a mindset that every diabetic patient should learn and need to have, to work well with their own specialist, and not to rely too much on their own experience or feelings, in order to get the best treatment results.