Objectives: To assess the knowledge, attitude and practices of subjects with diabetes on insulin therapy. Materials and Methods: A questionnaire based cross-sectional study was done at Karnataka Institute of Endocrinology and Research, Bangalore in 448 subjects with diabetes on insulin therapy. Results: 61.38% subjects were men and 44.9% subjects were in the age group of > 60 years. Premixed insulin was the most commonly used insulin regimen (81.47%). Most of the subjects were on conventional insulin (86.8%). Insulin syringe was the most commonly used delivery device (64.7%). 13.1% of subjects were using non corresponding syringes with insulin vials. 94.9% subjects were regular with insulin therapy. 70.5% subjects were self-injecting insulin and 85.4% subjects were rotating the injection sites. Only 20.1% self adjusted the insulin dose. Only 50.7% subjects used the pinch up technique. 45.91% subjects used 90-degree angulation for insulin injection. 49.4% subjects found insulin therapy to be painful. Local site reactions were noted in 32.1% subjects. Conclusions: Our study has found several errors in insulin injection technique that needs to be circumvented by pre-injection counselling and periodic reassessment by the clinicians.