Categorically, about 50 per cent of diabetic patients are well controlled by dietary restriction alone, while the remainder require insulin coupled with such dietary restriction.1Of the latter group "at least one half of them can be balanced without difficulty by the use of moderate amounts of almost any type of insulin."1a The remaining 25 per cent who comprise the third category are characterized as having severe diabetes.1aIf the clinician is not a "purist"2or a "free dieter"2he may achieve relatively good control in the vast majority of these severe cases. The "purist" approach is unwise here since it frequently invites hypoglycemic reactions. Conversely, the "free dieter" is often defeated in his therapeutic objective by repeated insults of severe hyperglycemia, glycosuria and even ketosis. Successful management in this group, therefore, is usually the reward of the "middle of the roader"2whose therapeutic