The literature on type II (noninsulin-dependent diabetes mellitus) proposes many forms of treatment. This diversity suggests that there is no single best way to treat this condition. At Oregon Health Sciences University, we have been using the combination of insulin given in the evening and sulfonylurea drugs given during the day as an alternative to multiple-dose insulin regimens when diet or diet and oral hypoglycemic agent therapies do not achieve adequate glucose control. This approach, while effective in our experience, is not widely accepted. This paper reviews the literature on combined insulin and sulfonylurea therapy for treatment of certain stages of type II diabetes, the rationale for use of this therapy, and our experience to date.