Type 2 diabetes, 97% male, median follow-up 5.6 years, inadequate response to maximal doses of oral agents or insulin therapy.Mean age 60.4 yearsExclusions: HbA1c <7.5%, cardiovascular event during previous 6 months, advanced congestive heart failure, severe angina, life expectancy <7 years, BMI>40, serum creatinine level >141 micromol/L, alanine aminotransferase level > three times the upper limit of normal. This evidence concerns the gene INS and congestive heart failure.