Type 2 diabetes mellitus can often be treated initially with a modified diet, exercise and oral antihyperglycaemic agents. However, insulin therapy is often eventually required by many patients with type 2 diabetes to obtain optimal glucose control, which is essential for reducing the risk of long-term complications. A major barrier to insulin use is patients' psychological insulin resistance, or a delay in insulin therapy because of a concern about the social stigma attached to the use of syringes, a fear of needles, or worries about the restrictions and inconvenience of daily injections. In addition, many physicians may have their own concerns about patients experiencing hypoglycaemia and weight gain, and may believe they have inadequate time to instruct and support patients during the initiation of insulin use. The Diabetes Attitudes, Wishes and Needs (DAWN) study examined these issues, and their impact on insulin prescribing, and the results of the study were presented at a poster session at the 18th International Diabetes Federation Congress [Paris, France; August 2003].