Resistance to start insulin therapy in a timely manner in type 2 diabetes mellitus (T2DM) has been identified as an important barrier to achieve recommended levels of glycemic control.
Diabetes does not immediately cause a major discernible problems for a patient. My guess is that daily (multiple) injections may seem too aggressive a therapy to those who do not quite understand the long-term ramifications of the problem and hope that they may be able to manage without insulin injections.
In your country, is it possible that there may be an additional factor related to religion? In the past, porcine insulin was used for treatment of diabetes. Very religious people, who are not fully informed, may still have doubts about the source of insulin and may consider it not halal... just a thought!
I should thank you for your opinion. Actually, I agree with you. Furthermore, in my country based on my knowledge and published papers in this topic, studies demonstrated that some reasons including fear of injection, being afraid of weight gain, or hardship of injection are common reasons; and according to my area of knowledge religious factors are not associated with this matter.
Don't forget to pull citations on clinical/clinician inertia. It's not just the patients who are reluctant to initiate insulin therapy to achieve glycemic control targets.