The selection of initial pharmacotherapy is based on a detailed consideration of the clinical and bio-chemical characteristics of the patient. Safety con-siderations must always be carefully considered since few, If any , antidiabetic agenents are completely devoid of risk; some are appreciably more hazard-ous than others in certain clinical scenarios (seesection4) . An assessment of the biochemical phenol-type of the patient is required. However, in practice it can be difficult to judge whether insulin resistance or insulin deficienycy is the dominant defect. As a rule, although it should be stressed ,not invariably, younger patints at near-normal bodyweight are more likely to have greater insulin deficiency than