Secondary failure of oral hypoglycaemic agents raises the dilemma of whether to institute therapy with insulin alone, or in combination, We reviewed our experience of combination therapy following secondary failure of oral hypoglycaemic therapy, Seventeen subjects were receiving combination therapy for 6 months or more, Such treatment was associated with a significant fall in HbA(1)C-from 10.7+/-0.38 per cent to 8.3+/-0.35 per cent (p<0.01) after 6 months and remained significantly reduced at 12 months (8.7+/-0.34 per cent (p<0.01)), Mean body weight, systolic and diastolic blood pressure were unchanged during treatment with adjuvant insulin therapy, Insulin therapy is a useful adjunct in the daily management of subjects with NIDDM who experience secondary failure of oral hypoglycaemic agents.