OBJECTIVES: This study evaluated real world outcomes for type 2 diabetes (T2D) patients treated with analog basal insulin (glargine or detemir) on glycemic control and weight after 6 months in a national electronic medical record (EMR) database. METHODS: Patient data were extracted from the General Electric (GE) EMR database from January 1, 2000 through December 31, 2007. Patients were ≥18 years old with T2D defined by ICD-9 codes, ≥2 fasting blood glucose levels ≥126mg/dL, or A1C >7.0%. Patients had prescription orders in the previous 395 days for metformin, a sulfonylurea or a thiazolidinedione, alone or in combination, or had no prior antidiabetic treatment. Patients were initiated on a basal insulin with no prior insulin use, had no other insulin prescribed within six months of basal insulin initiation, and had at least one additional order for the prescribed basal insulin within six months. Baseline A1C and weight were documented ≤45 days prior to ≥15 days post basal insulin initiation and at six months post initiation ±45 days. RESULTS: Of patients with 6 month A1C or weight follow-up data (n=841 and n=1817, respectively), mean (±SD) baseline A1C was 9.0±1.9% and weight was 99±25.0 kg. Mean BMI was 34.7±8.1 kg/m2. The majority were treated with insulin glargine (n=1754; 91.2%). At six months mean (SEM) A1C reduction was -1.2(0.1)% with 20.0% (n=393) achieving A1C goal of <7.0%;. Mean weight gain was 1.0(0.1) kg (p<.001) and 60% (n=1103) of patients gained weight. CONCLUSIONS: In a real world setting, most patients (80%) did not reach ADA targets for glycemic control with analog basal insulin treatment. Additionally, the majority of patients (60%) experienced weight gain.