OBJECTIVES: Using the Dutch PHARMO database, the aim was to 1) determine the percentage of type 2 diabetes (T2D) patients starting on long-acting insulin analogues versus NPH; 2) compare previous insulin experience in patients; and 3) establish the number of patients changing treatment within one year. METHODS: The PHARMO database includes community pharmacy drug dispensing and hospitalisation records from approximately 2.5 million patients. Data was extracted for insulin naïve and prior insulin T2D patients initiated on basal insulin as monotherapy or as part of a basal-bolus regimen in 2004-2006. RESULTS: The study included 7209 new basal insulin users, of which 4792 (67%) were insulin naive. Overall, 4728 (66%) used analogues, with similar proportions using monotherapy (67%) and basal-bolus therapy (65%). The proportion of analogue users was greater among prior insulin users: 541 of 619 (87%) for monotherapy and 1331 of 1798 (74%) for basal-bolus therapy compared with 2258 of 3702 (61%) and 598 of 1090 (55%) among naïve users. Monotherapy for naïve patients was initiated mainly by the GP (NPH 70%, analogue 59%), for prior users mainly by the internist (NPH 49%, analogue 59%)%), same as for basal-bolus users (NPH 67-68%, analogue 75-80%). With NPH, 22% discontinued their prescription (average of 220 days) and with basal analogues 17% (average of 230 days). Furthermore, 6% of patients on NPH and 11% with basal analogues added-on to their prescription (after an average of 119 days and 126 days, respectively). Only 17% of patients switched treatment with basal analogues compared with NPH (average of 190 days) versus 32% (average of 158 days), respectively.   CONCLUSIONS: When new insulin treatment is initiated, analogues are more often prescribed than NPH, more frequently prescribed by Dutch internists and not discontinued or switched as frequently as NPH, indicating that basal insulin analogues give a more sustained and satisfactory result.