Control of type 2 diabetes mellitus (DM) has deteriorated rather than improved during the last decade in the United States, despite a greater understanding of the disease and the availability of various therapeutic options. Achieving recommended glycemic targets in patients with type 2 DM requires overcoming several barriers, including the fear of hypoglycemia and its associated consequences. Insulin analogues offer new options in diabetes management and may help patients achieve better glycemic control while limiting the incidence of hypoglycemic episodes. Greater awareness of the symptoms of hypoglycemia, intensified blood glucose self-monitoring, and new diabetes treatment options allow for achievement of glycemic targets without increased risk of hypoglycemic episodes. A case study of a 63-year-old woman with type 2 DM offers important lessons learned in diabetes management.