Because type 2 diabetes mellitus is a progressive disease, most patients eventually need insulin. When and how to start insulin therapy are not one-size-fits-all decisions; rather, treatment must be individualized. This paper reviews the indications, goals, and options for insulin therapy in type 2 diabetes. To read the full article, go to the Cleveland Clinic Journal of Medicine: http://www.ccjm.org/topics/diabetes-endocrinology-metabolism/single-article-page/starting-insulin-in-patients-with-type-2-diabetes-an-individualized-approach/91326715dbccf29fbb7b1d9d93a420e5.html.