Objective: To compare the glycaemic control with insulin detemir administered according to titration algorithms 3-0-3 and 2-4-6-8 after 20 weeks of treatment in subjects with T2DM inadequately controlled on metformin. Additionally to evaluate the difference in hypoglycaemia episodes during 0 -12 weeks and 12- 20 weeks of treatment. Methods: This was a 20-week, randomised, multi-centre, open-labelled, treat to target trial. 46 patients were randomised in a 1:1 manner to either 3-0-3 (G3, n = 23) or 2-4-6-8 (G2, n = 23) group. The primary endpoint was change of the HbA1c and secondary safety endpoint included hypoglycemic events. Results: After 20 weeks, Change in HbA1c decreased similarly in G3 vs G2 (-0.9% from 10 % vs -0.9% from 9.5 % at baseline) with a mean change of -0.9% from baseline. The mean change in FPG was numerically similar in both groups(G3 vs G2 : -60.4 from 204.1 vs -56.4 from 182.9 mg/dL at baseline). The mean of 7-point SMBG profile was observed to decrease more in G2 (68.4 mg/dL) compared to G3 (59.9 mg/dL) after 20 weeks of treatment. The hypoglycaemia event rate per 100 patient years of exposure(R) in 2-4-6-8 algorithm group was (R = 1427) which was higher than that in 3-0-3 group (R = 807). There were no severe hypoglycaemic episodes reported in both groups. A further sub-analysis evaluating overall hypoglycemia episodes during 0-12 weeks and 12 weeks to EOT revealed significantly fewer episodes with the 3-0-3 group (9 vs 16; P < 0.05) during 12 weeks to EOT with no differences in occurance of nocturnal hypoglycaemia. Conclusion: Both the treatment groups had numerically similar HbA1c reductions after 20 weeks of treatment. A trend towards fewer hypoglycaemia episodes post dose stabilisation was seen with the simpler 3-0-3 algorithm. Clinically, this may be important as a simpler titration algorithm may support self management and maintenance of insulin therapy with similar glycaemic control and fewer hypoglycaemia episodes.