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[Which insulin for which patients in 2014].

Initiation of insulin treatment is a major step in the care of type 2 diabetic patients; it implicates a thorough discussion with the patient, therapeutic education and objectives shared by both physician and patient. The standard is an injection of basal insulin per day with either NPH insulin or a basal insulin analogue, such as detemir, glargine or degludec. The basal analogues have less side effects, weight gain and hypoglycemia, a more reproductible profile and a longer duration of action compared to NPH insulin. The injection can be made in the evening or in the morning depending on the dose and the glycemic profile. Oral antidiabetics can be maintained. More complicated insulin regimen are sometimes necessary but often induce more side effects with less compliance and little additional benefits.