Diabetes mellitus is one of the major causes of premature morbidity and mortality. Studies show that intensive glycaemic control could significantly reduce the risk of diabetic complications. With the increasing number of diabetic patients under primary care indicated for insulin, family physicians will play a pivotal role in prescribing it in their setting. The initiation and titration of any insulin regimen is not difficult in most patients. With support from diabetes nurses and training on insulin use, family physicians can provide insulin therapy to diabetic patients in the community and reduce the number of referrals to secondary care. This article reviews the most updated clinical guidelines on insulin use to better equip family physicians on the initiation and titration of insulin in primary care.