Therefore, the issue of solid combinations. Currently, the combination of SAP and finished metformina. Insulinoterapiya SD2 number of patients requiring treatment with insulin, which has been steadily increasing, long surpassing the number of patients SD1. Unfortunately, there are many reasons (more psychological than objective), because that insulinoterapiya in SD2 are often assigned too late and is seen as the last chance for treatment SD. In fact, bearing in mind the heterogeneity SD2 can say that, in some cases, insulin should be appointed very soon, if not from the onset. Not in the modern classification of the board of directors did not recommend more use of the term insulinnezavisimy SD, as not reflecting the true pathogenetic mechanisms. Given the current state of knowledge about the development of complications SD use insulin should start if other treatments do not keep HbA1c levels less than 8%. Speaking of patofiziologicheskih aspects of the treatment of patients with insulin SD2, it should be noted that it may go some way to improving the three major defect : lack of secreting insulin, produce excess glucose liver and reducing peripheral glucose utilization. Objectives insulinoterapii in SD2 may be as follows : 1. Warning ketoatsidoza and giperglikemicheskoy coma. 2. Addressing symptoms such as frequent urination, thirst, dry mouth, etc. 3. Restoration of body weight (after a loss) to improve the ability to exercise and perform their work. 4. Improved facilities, and hence the quality of life for patients. 5. Reducing the frequency and extent of infectious processes. 6. Prevention and micro makrososudistyh complications.