Background: As type 2 DM is a growing health problem worldwide early treatment andrnintensification of therapy will decrease the vascular complications as evidenced by large trials.rnInsulin therapy is delayed in this group of patients and multiple physician and patient factors are rnmentioned in different settings. rnObjective: This study aims to assess patientsâ€™ and physiciansâ€™ knowledge, practice, andrnattitude towards insulin therapy in Type 2 DM to answer the reason for not early insulinrninitiation by physicians and the patientsâ€™ refusal to start insulin therapy. rnMethods: This study is a cross-sectional, quantitative descriptive study conducted onrn221patients at TASH endocrine clinic and 122 physicians working at TASH, residents visiting rnfor detachment, and Yekatit 12 hospital. Conducted on Jul 1- Sep 30, 2020, G.C rnResult: 76% of physicians think taking insulin at the prescribed time is difficult while onlyrn31.5% of patients think itâ€™s difficult. Hypoglycemia is one of the most fearful parts of havingrndiabetes for 81.1% of patients on Insulin therapy. 87% of physicians and76.6% of patients think rninsulin-treated diabetes controls life while. 56% of patients therapy know nothing about insulinrntherapy. 23% of patients said they will not accept insulin therapy the top reason being they willrnbe afraid of insulin injection because they think it will be painful. rnConclusion: Physicians tend to overestimate the difficulty of insulin injection preparation andrndose adjustment fears the risk of hypoglycemia when starting insulin therapy. More than half ofrnour patients not on insulin therapy know nothing about insulin therapy which we have to rnimprove. Even if patients not on insulin therapy overestimate insulin needle phobia and injectionrnpain those who are already on insulin disagree with them.