GDAL, the Geospatial Data Abstraction Library
Is a great set of tools for managing data with a spatial data type.
Spatial Metadata Tables
Two tables are created for letting the user (and applications) know where the spatial column is in what tables they are located, and what the projection is. This is all in another post.
You can load the database using ogr2ogr. This will handily create the spatial metadata tables for you during load.
For example, on MSSQL server, loading from a shape file in WGS84 (EPSG: 4326) to WA State Plane (EPSG 2927):
ogr2ogr -overwrite -progress -f MSSQLSpatial “MSSQL:server=SERVER1;database=GPSTrails;trusted_connection=yes” Points.shp -s_srs EPSG:4326 -t_srs EPSG:2927
Here I am overwriting the table if it exists, showing progress information, indicating that I have a trusted connection converting from 4326 to 2927.
If you look over the data types you can use for ogr2ogr, you can see that you could load from sqlite, ESRI FileGeodatabase, csv, and doxens of other formats.