With the introduction of insulin detemir (Levemir [Novo Nordisk A/S, Bagsvaerd, Denmark]), a long-acting basal insulin analog, it is an opportune moment to reevaluate the use of basal insulin therapy and consider current treatment strategies, including the use of insulin detemir. This review examines the need for effective treatment options for diabetes and the economic burden of this disease. The importance of achieving glycemic control targets and the role of basal insulin therapy are discussed. Finally, the use of insulin detemir is briefly reviewed with a look at its clinical pharmacology, its use in basal insulin therapy, and its cost-effectiveness.