I'm going to climb onto a soapbox here. Please bear with me. :)
Insulin is not something to be afraid of. But people (and doctors, who are supposed to know better!) are reluctant to use it for a lot of reasons.
One huge point of resistance comes from the fact that nearly everyone knows, or knows of, someone who had serious complications, was put on insulin and then declined rapidly. So they associate the failure with insulin, which is nonsense. The rapid decline in such a case is due not to the insulin but to the fact that it was prescribed too late to do any good. The appalling tragedy of cases like this is that if insulin had been prescribed early enough, the patient's condition probably would never have gotten that bad to begin with. An outrage, IMHO.
Many doctors are reluctant to prescribe insulin because they think patients are terrified of injections. And some people do have this phobia, no question. But the disparity between the number of people who actually are afraid of injections, and the number of people who doctors think are afraid, is great. I've seen surveys in which both doctors and patients were asked about their attitudes. Upwards of 60% of the doctors said they don't prescribe insulin because patients fear injections. But only around 20% to 25% of the patients in those surveys said they feared them. That's a lot of people who could be benefiting and aren't.
The crux of the issue is that both doctors and patients view insulin as a "last resort". Which is utterly absurd. Insulin is just a tool, like metformin or physical therapy for an injury. The key to solving a problem effectively and efficiently is to use the right tool for the job.
If you had a broken leg, would you put off the hassle of having a cast? Would you look on it as a "last resort" and delay as long as possible? Obviously not. You'd want it and you'd want it RIGHT NOW. Right tool for the job. That's all.
When I realized I was never going to get the control I wanted with pills, I went in and demanded insulin. To say it has been life-changing is an understatement. My control is better by an order of magnitude than it's ever been. In hindsight I wish I had done it years sooner.
I'll end this with one simple thought. The world renowned Joslin clinic now starts every newly diagnosed diabetic on insulin right away. Hmmmm. Perhaps they know something?