Insulin therapy optimization is critical for achieving effective glycemic control and minimizing complications in patients with Type 1 and advanced Type 2 diabetes. Personalized dosing strategies, including basal-bolus regimens and pre-meal insulin adjustments, are tailored to individual metabolic needs, lifestyle, and glucose monitoring data. Technological advancements such as insulin pumps, continuous subcutaneous insulin infusion, and closed-loop “artificial pancreas” systems provide precise, automated insulin delivery, improving glucose stability and reducing hypoglycemia risk. Combination therapies with oral agents or adjunctive medications further enhance efficacy and flexibility. Optimizing insulin therapy involves a patient-centered approach, integrating continuous education, monitoring, and behavioral support to ensure adherence, improve quality of life, and achieve long-term metabolic targets.