Insulin therapy is a proven therapeutic option for the control of type 2 diabetes in clinical practice. The rational application of insulin has an irreplaceable role in controlling acute metabolic disorders of diabetes and preventing various chronic complications. However, in clinical work, some patients and even doctors have misunderstandings about insulin. The common misconceptions about insulin use are summarized here to solve the confusion of doctors and patients. Myth 1: The use of insulin will lead to obesity The use of insulin therapy may increase the weight of patients to varying degrees, but as long as it is used in a reasonable manner and the lifestyle is adjusted, it is entirely possible to maintain the “figure” while controlling blood sugar. First of all, we should make sure that the insulin dosage is reasonable and avoid defensive eating caused by hypoglycemia. Second, control calorie intake, eat more vegetables, coarse grains and other low-calorie foods, and take a half-hour walk after three meals to increase calorie consumption. The combined use of insulin and oral hypoglycemic drugs can reduce the insulin dose, thus reducing the weight gain of patients. Myth 2: Insulin injection will be very painful The development of insulin injection devices has undergone a process from special syringes to insulin pens and insulin pumps; at the same time, insulin injection pen needles are constantly updated, and the needles tend to be shorter and thinner to adapt to the requirements of subcutaneous insulin injection, which further reduces the pain of injection while improving the effectiveness and safety of injection. In addition, there are very few nerve endings at the insulin injection site, which also greatly reduces the level of pain. Patients may feel a little discomfort when they first start using insulin injections, but when they master the insulin injection technique and gradually get used to it, the treatment compliance of insulin injections will not be lower than that of taking medication. Although hypoglycemia is the most important side effect of insulin and the main reason for patients to achieve the blood glucose standard, it can be avoided to the greatest extent if the dose is reasonable and the injection is done correctly. Community physicians should provide more diabetes education to patients receiving insulin therapy, enhance patients’ awareness of self-management and self-monitoring of blood glucose, and guide patients to safely meet their blood glucose targets. In addition, more and more insulin analogues are being used in the clinic, and these analogues can better mimic the physiological insulin secretion pattern. Patients who have hypoglycemia with human insulin therapy can consider switching to insulin analogue therapy. Myth 4: Insulin use will be “addictive” Some patients worry that once they start using insulin therapy, they will become “addicted” and need to use it for the rest of their lives, and the dose will become larger and larger. As diabetes progresses, the secretion function of pancreatic beta cells will gradually decrease, and some patients will need to use insulin for a long time to control blood sugar, which is the result of the natural progression of the disease, not addiction after using insulin. On the contrary, many community doctors found in their clinical work that many newly diagnosed type 2 diabetic patients using human insulin (such as eugenol 70/30), after short-term treatment, their hyperglycemia was controlled, their symptoms were relieved, and they were able to reduce their insulin dose and even switch to oral medication or diet control and exercise therapy. This shows that insulin is not an “addictive” drug, and the need for long-term insulin therapy is determined by the function of pancreatic beta cells. It is wrong to believe that once insulin is started, it needs to be used for life. Myth 5: Newly diagnosed type 2 diabetes does not require insulin therapy For patients with initial type 2 diabetes with high blood glucose, it is difficult to achieve satisfactory control of blood glucose with oral medication in a short period of time. Some studies have shown that intensive insulin therapy can enable most newly diagnosed type 2 diabetes patients to obtain glycemic control and protect pancreatic β-cell function, improve insulin secretion in the first phase, reduce insulin resistance and improve blood lipids, and its effect is significantly better than short-term intensive treatment with oral hypoglycemic drugs. The mechanism may be that insulin therapy can effectively control hyperglycemia and maximize the relief of glucotoxic effects, while it can inhibit lipolysis and reduce lipotoxicity, thus it can improve insulin resistance and protect pancreatic β-cell function. In addition, insulin has direct anti-inflammatory and anti-atherosclerotic effects. Therefore, when newly diagnosed type 2 diabetes mellitus is accompanied by significant hyperglycemia, it can be treated with insulin for a short period of time, and the regimen can be adjusted according to the condition after the hyperglycemia is controlled and the symptoms are relieved. Myth 6: Using insulin means deterioration and treatment failure In the traditional concept, type 2 diabetes generally starts this treatment only when the disease progresses to the point where insulin has to be used, but now the concept of insulin treatment has changed greatly, and insulin treatment should be activated as early as possible in order to achieve the blood glucose standard and restore beta cell function as early as possible. Type 2 diabetes itself is a progressive disease, and as the disease progresses, the secretion function of pancreatic beta cells will gradually decrease, and the original effective diet, exercise and oral drug therapy may gradually fail. The 2010 Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes state that insulin therapy can be started when two oral medications are combined and the blood glucose still does not reach the standard. The results of an increasing number of studies in recent years have shown that early intensive insulin therapy to control blood glucose has lasting benefits by reducing glucotoxicity, lipotoxicity and controlling inflammation, which can delay the onset of diabetic complications.