Background <p>As type 2 diabetes is a growing health problem worldwide, targeting an early treatment and intensification of therapy will decrease the associated morbidity and mortality as evidenced by large trials. Insulin therapy is delayed in this group of patients and multiple physician and patient factors have been mentioned in different settings.</p> Methods <p>A cross-sectional, hospital-based, quantitative study was conducted among 221 people with type 2 diabetes attending Tikur Anbessa Specialized Hospital endocrine clinic and 122 physicians who were working at this clinic. The study was conducted from July 1, 2020 to September 30, 2020.</p> Result <p>About 31.5% of the patients reported taking insulin at the prescribed time was difficult while this difficulty was mentioned by 76% of the physicians. Hypoglycemia was found to be one of the most feared parts of having diabetes in 81.1% of patients on Insulin therapy. 87% of physicians and 76.6% of patients think insulin-treated diabetes controls life while. 56% of patients on non insulin therapy know nothing about insulin therapy. 23% of patients said they will not accept insulin therapy the top reason being they will be afraid of insulin injection because they think it will be painful.</p> Conclusion <p>Physicians tend to overestimate the difficulty of insulin injection preparation and dose adjustment was feared for the risk of hypoglycemia when starting insulin therapy. More than half of the patients who did not initiate insulin therapy know nothing about insulin therapy and this needs to improve. Even if patients not on insulin therapy overestimate insulin needle phobia and injection pain those who are already on insulin disagreed with them.</p>