OBJECTIVES: study compared the daily average consumption (DACON) of insulin detemir (DET), insulin glargine (GLAR) and NPH insulin in patients with T2D in a real-world setting. METHODS: Patients with T2D (per ICD-9 code 250.x1 250.x3) newly treated with DET, GLAR or NPH insulin monotherapy were identified in the Verispan Electronic Data Warehouse (SDI, Plymouth Meeting, PA) from 7/1/2006 to 6/31/2007. A study limitation is that Verispan data has an open architecture and does not include eligibility data, but filtering techniques were employed to eliminate cohort shrinkage. A patient level DACON was calculated as the number of insulin units dispensed from the first to the second to last prescription in the observation period divided by the elapsed days from the first to last fill. Unpaired t-tests and chi-square tests were used to identify differences between GLAR or NPH and DET for continuous and categorical variables respectively. A Wilcoxon rank sum test was used to identify differences in mean DACON between GLAR or NPH and DET. RESULTS: Of the 21,881 patients identified, 2215 (10.1%) were treated with DET, 16,548 (75.6%) with GLAR, and 3118 (14.3%) with NPH. A higher percentage of NPH users were above 65 years (42.4%) compared to GLAR (35.2%) and DET (31.2%) (p<.001). Mean/median DACON as units/day were 35/26 for DET, 32/27 for GLAR (p=0.06) and 41/32 for NPH (p<.001). A higher percentage of DET patients had prior antidiabetic use compared to GLAR and NPH users (75.8%, 67.8% 52.3% respectively, p<.001). The percentage using multiple antidiabetic agents before the observation period was highest for DET (56.3%), followed by GLAR (45.7%) and NPH (29.5%) (p<.001). CONCLUSIONS: DACON was highest with NPH and did not vary between DET and GLAR. A greater proportion of DET patients were treated with multiple antidiabetic agents prior to insulin start, suggesting more severe diabetes.