Background: Type 2 diabetes mellitus (T2DM) is a progressive disorder of β-cell dysfunction until majority of patients with a longer duration of diabetes remain poorly controlled with oral agents, and use of insulin, which could improve glycemic control .Guidelines from the American Diabetes Association and the European Association for the Study of Diabetes recommend that insulin secretagogues such as sulfonylureas be discontinued at the time of insulin initiation to reduce the risk of hypoglycemia, and that treatment be intensified if HbA1c levels remain above-target 3 months after insulin initiation. Study design and methods: It was a prospective study and patients diagnosed with T2DM initiating insulin and no prior insulin use. The study duration was six months (December 2016 to May 2017) among type 2 diabetes mellitus patients at Karuna Medical College and Hospital, Diabetic centre, Quality clinic-Palakkad. Result and Discussion: Out of total 308 study populations, 226(73.37%) were taking Human insulin, 82(26.62%) were taking Insulin analogues. Conclusion: Human insulin dominate the prescribing pattern, but there was a shifting trend towards the use of insulin analogue preparations in the management of Type 2 diabetes mellitus. In achieving optimal glycemic control, intensification of current insulin treatment as well as planning multiple drug interventions with lifestyle modification is necessary.