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Dr Spellman discloses that he is a member of the speakers bureau for Amylin Pharmaceuticals, Inc; Novartis Pharmaceuticals; Novo Nordisk; and The sanofiaventis Group. He has participated in clinical trials with AstraZeneca LP; Bristol-Meyers Squibb Company; Genentech, Inc; GlaxoSmithKline; Merck & Co, Inc; Novartis Pharmaceuticals; Pfizer, Inc; and The sanofi-aventis Group, for which he has also served as a consultant.

Address correspondence to Craig W. Spellman, PhD, DO, Divisions of Internal Medicine and Endocrinology, University of North Texas Health Science Center at Fort Worth, 855 Montgomery St, Fort Worth, TX 76107-2699. E-mail: cspellma{at}hsc.unt.edu

Type 2 diabetes mellitus is on the rise, yet glycemic control continues to elude patients—and their physicians. During the past decade, the use of insulin monotherapy has decreased while the use of oral antidiabetic agents (either alone or in combination with insulin injections) has increased. The continued prevalence of the disorder, changes in prescribing patterns, and recent data indicating that only one third of patients with type 2 diabetes mellitus achieve glycemic control underscore the need for physicians to reevaluate the clinical management of this now common disorder. Insulin analogs provide flexibility in the delivery of insulin therapy for this population. Although potential barriers and complications to initiation exist, patients should understand that achieving and maintaining glycemic control reduces the risk of long-term complications as a result of type 2 diabetes mellitus. Physicians are encouraged to actively identify and address patient concerns about this treatment modality.