The purpose of this preliminary study is to seek out an explanation for how patients with failure of oral glucose-lowering agents perceived low need to start the insulin therapy. The objective is to promote a patient-centered intervention. The intentional non-adherent is frequently observed among patients who required insulin. Although the psychological insulin resistant is recognized as a barrier to prevent this treatment modality change, little is known about the mechanism underlying the low perceived need for insulin therapy that would be a potential facilitator for this change. We conducted a phenomenological approach to explore the perceived reality about illness and medication form patient’s perspective. The study adopted purposive sampling and face to face interviews. Patients who had been recommended with insulin therapy but delay at least 6months were invited to participate in the study. The dialectic interpretive process was adapted as a method to identify significant information for coding, categorization, and theming. We analysed 6 patients. The preliminary findings were converged into three main theme categories: sense of control, self defined risk as safety, and prototype of insulin therapy. This research demonstrated that it is insufficient to overcome the psychological barriers without integrating the context of the patient perceived need about the insulin therapy. From patients’ perspective, the necessity of insulin therapy was decided by a self care oriented rather a medical oriented approach. It can be suggestion that the message about treatment recommendation should be tailored to the individual perceptions of their health threat.