OBJECTIVES: The objective of this study was to assess the impact of early basal insulinisation with Lantus in people with type-2 diabetes failing to reach optimal glucose control with oral therapy. METHODS: The Canadian INSIGHT study was a 24-week trial of patients with Type-2 diabetes randomized to receive insulin glargine added to current therapy, or adjusted oral therapy. Nineteen endocrinologists or experts selected 34 family physicians for a mentor/preceptor relationship, facilitating insulin initiation. Treatment satisfaction (TS) and quality of life (QoL) were also assessed for all 405 patients randomized to either the glargine (206) or the adjusted oral therapy arm (199). TS and QoL were assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Audit of Diabetes Dependant QoL (ADDQoL) questionnaire. Both self-administered questionnaires were administered at baseline, week 12 and 24. A total of 376 and 364 patients completed the DTSQ and the ADDQoL questionnaires, respectively. RESULTS At baseline, TS and QoL were similar in both treatment arms. A1c reduction was greater with glargine (p<0.001). The total DTSQ score and the TS items (items 1, 4, to 8) improved from baseline in both treatment arms (p<0.001); however, there was significantly more satisfaction with treatment with insulin glargine for the DTSQ total score (p=0.024) and the TS items (p=0.011). Perceived frequency of hyperglycaemia and hypoglycaemia (DTSQ items 2 and 3) were significantly (P<0.05) lower at week 12 and 24 for all subjects with no distinguishable differences for the two treatment arms at week 24. Only perceived hyperglycemia was significantly (P<0.01) lower for glargine at week 12. Finally, overall QoL improved in both groups (p<0.001); however, glargine had a greater impact at week 12 (p=0.025) and endpoint (p=0.024). CONCLUSIONS: Improving glucose control with glargine had a positive impact on TS and general QoL without complaints related to hypoglycemia.