This course examines the complexities of insulin titration and management in patients with diverse clinical backgrounds. It focuses on strategies for initiating and intensifying insulin therapy, particularly for patients with type 2 diabetes who have not achieved glycemic targets through oral medications or GLP-1 receptor agonists. The content emphasizes individualized glycemic goals that account for age, life expectancy, hypoglycemia risk, and the presence of comorbid conditions like chronic kidney disease. Clinicians will gain actionable guidance on navigating the challenges of regimen complexity, weight gain, and hypoglycemia to optimize patient safety and adherence.