OBJECTIVES: To summarize the economic, clinical, and health resource utilization (HRU) outcomes associated with MDI for patients with T2DM. METHODS: A literature review of studies published between January 2008 and January 2018 was conducted using PubMed and conference proceedings from June 2016 - June 2018. Studies were limited to those published in English and conducted in patients with T2DM on MDI. Studies including inpatients, older persons, pregnant women, or patients with an artificial pancreas or T1DM, or studies comparing insulin formulations were excluded. RESULTS: Of 2832 studies found, 38 studies reported economic, clinical, or HRU outcomes. Total annual U.S. healthcare costs for T2DM on MDI ranged from $20,553 to $42,020 and diabetes-related costs ranged from $8,180 to $14,248. Annual U.S. insulin costs ranged from $2,448 to $14,086. Regarding HRU, studies found that 14-24% of patients on MDI experienced ≥1 hospitalization and 24-34% experienced ≥1 ED visit annually. U.S. patients who switched from basal insulin to MDI experienced significant reductions in overall inpatient visits (-1.86 visits/patient-year), diabetes-related inpatient visits (-0.5 visits/patient-year), and diabetes-related office visits (-0.77 visits/patient-year). One study found that patients on MDI who switched to continuous subcutaneous insulin infusion (CSII) experienced significant reductions in ED visits (0.03 per subject per month (PSPM)), inpatient admissions (0.02 PSPM), and antidiabetic drug utilization (0.67 drugs per subject). The review found a reduction in HbA1c levels of approximately 2.0% for patients who switched from non-MDI insulin regimens to MDI. Patients who switched from MDI to CSII experienced reductions in HbA1c ranging from 1.0-1.5%. CONCLUSIONS: The review of the literature revealed economic burden and variations in HbA1c control among patients with T2DM on MDI. Additional research is needed on this understudied population to determine the effectiveness of various interventions in managing diabetes.