OBJECTIVES: Patient perceived barriers to intensifying treatment may lead to sub-optimal glycaemic control. This study assessed patient experience with insulin in Germany, preferences on insulin injection, and behaviours associated with intensification in insulin-treated type 2 diabetes mellitus (T2DM) patients.  METHODS: Adults with T2DM diagnosed >6 months ago and receiving insulin for ≥3 months were recruited through a representative online panel in Germany. Data were collected via an online questionnaire.  RESULTS: Of the 302 respondents, mean age was 56 years, with average 12 years since diagnosis and 7 years on insulin. Only 82% (247/302) knew their HbA with 37% (111/302) reporting HbA1c>8.0%. Overall, 87% (263/302) had BMI≥25kg/m, with 56% (169/302) BMI≥30. Basal-only insulin was used by 32% (96/302), short-acting (bolus) insulin only 13% (38/302), basal-bolus 47% (142/302), premix 7% (22/302). A total of 72% (216/302) reported ever having a non-severe (self-managed) hypoglycaemic event with 19% (42/216) of these reporting events occurring once-a-week or more. Also, 19% (57/302) reported at some point having a severe (requiring help to manage) hypoglycaemic event. 67% (201/302) respondents tested blood glucose 3-6 times daily. 12% (11/96) of the basal-only respondents had previously received basal-bolus but returned to long-acting insulin due to various issues. A total of 51% (49/96) currently on basal-only would hesitate to some degree if asked by their physician about intensifying treatment (switch to basal-bolus or premix). Most frequent reason was number of daily injections (39%, 19/49), followed by dose calculation and timing (37%, both 18/49), risk of hypoglycaemia (35%, 17/49) and weight gain (33%, 16/49). CONCLUSIONS: Number and timing of injections, dose calculation, risk of hypoglycaemia and weight gain may present barriers to insulin intensification among T2DM patients on basal insulin in Germany, and contribute to suboptimal HbA control. Therapies addressing these challenges may help to achieve treatment goals.