The second Diabetes Glucose and Myocardial Infarction (DIGAMI 2) study randomised patients with diabetes and myocardial infarction to insulin or oral-based treatment. To determine the effects of insulin-based treatment, the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and the Psychological General Well-Being (PGWB) Index were administered at baseline and 12 months. Insulin-treated patients (n = 197) had a worse risk profile and more co-morbidity at baseline than patients on oral glucose-lowering agents (n = 127). The treatment satisfaction and psychological well-being was similar between insulin and oral groups at baseline [DTSQ: median (first-third quartile) 30 (24-34) vs 31 (27-34), NS; PGWB: 77 (73-82) vs 79 (76-82), NS] and at 12 months [DTSQ: 32 (28-35) vs 34 (30-36), NS; PGWB: 81 (78-84) vs 82 (78-84), NS]. Improvement was significant in both groups. Insulin-based therapy was well accepted and did not decrease treatment satisfaction or psychological well-being compared to oral glucose-lowering treatment in patients with type 2 diabetes and myocardial infarction.