I worked very hard to try to get good control as a T2. I had all these books and followed Bernstein since 2006, but I couldn't achieve what I considered my target. But my doctors were basically happy if I was at 7-8%. I kept pushing my GP for insulin as the medications, diet and exercise were not enough, but no go. My GP absolutely refused to be the one to initiate insulin. So I was referred to an endo after more than a year of asking for insulin. And my endo turned out to be just as bad, constantly changing medications, the latest greatest drug, some costing me $200/month. But still refusing my request for insulin. In the end, I just threw up my hands and started insulin on my own. I did it smartly, I own all the books David S. mentioned, plus more. It has been two years, I dropped my A1c like 1% and have never had a serious hypo. Even more surprising, I have not gained any weight since starting insulin.
After starting, I made an appointment with a new endo and just presented myself at her door already having started insulin. She has no problem with it. In the end, I think that no doctor wanted to be "liable" for the decision to initiate insulin. Frankly, this is "my" diabetes and it is my decision, I just acted on it.