Part 1 of this article considers novel insulins and a-glucosidase inhibitors. The rapid-acting insulin analogues insulin lispro and insulin aspart are more convenient than conventional soluble insulin, and their adverse effects are as expected. Likewise, the prolonged-action insulins, glargine and detemir, have some advantages, without unexpected adverse effects, although there are potential safety concerns on theoretical grounds. The α-glucosidase inhibitor acarbose confers some therapeutic benefit, and rarely causes severe adverse effects, but it often causes unpleasant gastrointestinal discomfort. There are limited data on other drugs in the class.