OBJECTIVES: The progressive nature of Type-2 diabetes mellitus (T2DM) requires periodic intensification of therapy. Understanding the potential barriers to this from patients will support appropriate treatment selection. This study aimed to assess hypoglycaemic events, treatment convenience and potential barriers to treatment intensification in Italy.  METHODS: A web-based survey of subjects with type 2 diabetes, diagnosed >6 months previously and receiving insulin for ≥3 months, recruited via a representative online panel.  RESULTS: , with 24% (72/302) BMI>30kg/m, 75 (34%) had HbA>8.0%. Of the 72 with BMI>30kg/m>8.0%. A total of 42% (126/302) used basal-insulin only, 29% (88/302) bolus-insulin only, 22% (66/302) basal-bolus, 5% (16/302) premixed and 2% (6/302) other combinations. Of all respondents, 81% (246/302) had previously experienced non-severe (self-managed) hypoglycaemia (79% (59/75) in those with HbA>8%), with 11% (28/246) reporting 3 events per-week, 33% (80/246) once-a-week, and 29% (72/246) once-a-month. 30% (92/302) had previously experienced severe hypoglycaemia requiring help from others, with half (46/92) reporting 1-3 such events during past year. 73% (221/302) of respondents tested blood glucose 2-5 times-daily. Of 192 respondents using basal insulin, 134 (70%) injected ≤1 time-a-day, whilst 30% (58/192) injected ≥2 times-daily. When asked about intensifying by adding bolus-insulin or switching to premix, 58% (73/126) of basal-only patients would be hesitant. Most frequent reason for hesitation was increased number of daily injections (44%, 32/73), as well as pain/discomfort of injections and risk of weight gain (both 23%; 17/73), hypoglycaemia risk (22%; 16/73), difficulty calculating bolus dose with food (21%; 15/73). CONCLUSIONS: Number and timing of injections, dose calculation, risk of hypoglycaemia and weight gain are barriers to insulin intensification among T2DM patients on basal insulin in Italy. Therapies addressing these may help to achieve treatment goals.