T2DM patient should never require the use of insulin, but if they have been poorly managed over the years, enough oxidative damage can occur to their pancreas over the years that it loses its ability to produce insulin and they become T2DM insulin dependent. The use of insulin is complex--patients start with basal and then may progress to basal/bolus if their disease state continues to worsen. This lecture will discuss introductory yet clinically helpful ideas on starting and managing insulin in T2DM patients.