Type 2 diabetes occurs when the body does not make enough insulin or use it correctly. Some people require insulin, while others can manage their blood sugar levels through diet and exercise.

The Centers for Disease Control and Prevention (CDC) state that diabetes affects 37 million people in America, and about 90–95% have type 2 diabetes. It occurs when cells in the body do not respond to the insulin produced by the pancreas.

Insulin works to regulate blood sugar in the cells for energy. The pancreas continues to produce insulin but eventually cannot keep up with the body’s needs, and blood sugar levels rise. High blood sugar can cause problems with major organs such as the heart, kidneys, and eyes.

Type 2 diabetes may be manageable with diet and exercise or with a combination of healthy eating, exercise, insulin, or other medications.

Regardless of the treatment protocol, blood sugar checks must occur regularly.

This article discusses why doctors recommend insulin for some people with type 2 diabetes. It also outlines the benefits and risks of insulin and lists other treatments for the condition.

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People with type 2 diabetes may require insulin but not always. Some people can manage their blood sugar with a healthy diet and exercise, according to the American Diabetes Association (ADA). However, not everyone with type 2 diabetes can go without insulin or other medication, even with diet and exercise management.

Even if insulin is not a regular part of an individual’s diabetes management, it may become necessary at certain times, such as during pregnancy or hospitalization.

Learn more about insulin.

Once tests confirm that a person has diabetes, a doctor may prescribe certain medications to help manage blood sugar. Then, over weeks, months, or longer, while monitoring blood sugar levels, the doctor may determine that adding insulin is the best course of action to stabilize blood sugar levels.

Insulin medication is a substitute for the insulin that the body produces. It helps move sugar from the blood to other tissues, which use it for energy. It also minimizes sugar production in the liver.

Maintaining stable blood sugar can help people avoid health conditions such as:

Learn more about the effects of diabetes on the body.

Taking insulin requires monitoring food intake and activity. A common side effect is hypoglycemia, or low blood sugar, often caused by:

Low blood sugar can usually stabilize by eating something that contains sugar.

Other side effects related to insulin injections include:

  • itching and swelling at the injection site
  • fat buildup or breakdown at the injection site
  • weight gain
  • constipation

Learn more about hypoglycemia.

There are several treatment options for type 2 diabetes, including diet, exercise, and medications.


According to the ADA, there is no perfect diet for managing diabetes. After extensive research, they concluded that everybody responds uniquely to different foods. However, there are a few fundamental guidelines.

The ADA recommends the diabetes plate method. People with diabetes should fill half the plate with nonstarchy vegetables, one-quarter with lean protein, and one-quarter with healthy carbohydrates.

If possible, people can work with a registered dietitian or nutritionist to create a balanced, sustainable eating plan.

Learn more about foods for diabetes.


One 2018 study evaluated the safety and effectiveness of different types of exercise for people with type 2 diabetes. They focused on aerobic, anaerobic, and resistance training exercise.

The researchers concluded that adults with diabetes should seek to perform 150 minutes per week of moderate-intensity aerobic exercise across at least 3 days, with no more than two consecutive days without exercise. If there are no limitations, people should practice resistance training twice a week.

Learn more about building muscle with exercise.


Doctors may prescribe different classes of drugs to lower blood sugar. These include:

  • Alpha-glucosidase inhibitors: These block the breakdown of starches and sugars to slow the increase in blood sugar following a meal.
  • Biguanides: Also known as metformin, biguanides decrease glucose produced by the liver.
  • Bile acid sequestrants: These help remove cholesterol from the body, which can rise with type 2 diabetes.
  • Dopamine-2 agonists: These lower blood sugar following meals.
  • DPP-4 inhibitors: These help the body make more insulin only when it’s needed and results in lower elevated blood sugar levels.
  • Meglitinides: People take meglitinides before meals to stimulate the release of insulin.
  • SGLT2 inhibitors: These help the body secrete excess glucose in urine.
  • Sulfonylureas: These stimulate beta cells in the pancreas to release more insulin.
  • Thiazolidinediones: These increase the insulin action in fat and muscle and lower glucose production in the liver.

Learn more about diabetes medication.

Type 2 diabetes is the most common form of diabetes. It develops when the body fails to make or use insulin correctly.

Some people can manage the condition through dietary changes and exercise. Other people take prescription medications, and some take insulin if a doctor prescribes it.

A doctor may recommend insulin if a person’s blood sugar levels are unstable. Insulin has few side effects, but reactions at injection sites and weight gain may occur.

Eating a healthy diet and being physically active can help stabilize blood sugar and improve overall health and well-being.