Two patients with severe refractory diabetes-related diarrhea are described. One patient had steatorrhea. Both responded to octreotide during a mean follow-up period of 7 months. The pathophysiology of diabetic diarrhea and the potential mechanism of action of octreotide are discussed. The only adverse side effect reported was hypoglycemia in one of the patients, which required a reduction of the insulin dose. Octreotide is a safe and effective agent for the treatment of refractory diabetic diarrhea.