Around 4% of the UK population have diabetes mellitus.1 Around 90% have type 2 disease and many of these people will need insulin therapy for effective control of their diabetes. The different types of insulin (animal, human or analogue), regimen (timing of doses and duration of action of insulin) and device (syringes, prefilled or disposable pens) present various advantages and disadvantages that can affect adherence, quality of life and glycaemic control.2 Here we provide an overview of the various treatment options available, and offer practical advice on how to choose the appropriate approach for adults with type 2 diabetes.