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

Diabetes is a fairly common condition in the United States, with type 2 diabetes (T2D) being the most common type. It occurs when cells in the body do not respond correctly to the insulin the pancreas produces.

Insulin regulates 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 issues with major organs such as the heart, kidneys, and eyes.

T2D may be manageable with diet and exercise or with a combination of balanced eating, exercise, insulin, or other medications. Regardless of the treatment plan, individuals must regularly monitor their blood sugar levels and try to keep them within their target range.

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T2D occurs when a person’s body is unable to use the hormone insulin correctly. In a person with the condition, the pancreas still produces insulin, but the body does not respond well to it. As such, some people with T2D 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 T2D 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.

When might doctors recommend 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.

Generally, a doctor may suggest insulin for a person with T2D if they experience severely high blood sugar levels, have underweight, or may have a misdiagnosis of type 1 diabetes (T1D).

Insulin medication is a substitute for the insulin that the body produces. Many different types of insulin work at different strengths, speeds, and durations. Insulin injections help 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 and complications such as:

Read on to 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 due to:

A person can stabilize low blood sugar by eating something that contains sugar.

Other side effects relating to insulin injections may include:

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

There are several treatment options for T2D, including diet, exercise, and medications.

Diet

According to the ADA, there is no ideal 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 need to fill a plate with the following proportions:

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

Read on to learn more about foods for diabetes.

Exercise

A 2018 study evaluated the safety and effectiveness of different types of exercise for people with T2D. The study focused on aerobic, anaerobic, and resistance training.

The researchers concluded that adults with diabetes should seek to perform 150 minutes of moderate-intensity aerobic exercise across at least 3 days per week, with no more than 2 consecutive days without exercise. If there are no limitations, people should practice resistance training twice a week.

Medication

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.
  • Glucagon-like peptide 1 (GLP-1) agonists: These drugs mimic the actions of the GLP-1 hormone, which the gut releases after eating. They help stimulate the pancreas to release insulin. Examples include semaglutide and dulaglutide.
  • Biguanides: Also known as metformin, biguanides decrease the glucose, or blood sugar, that the liver produces.
  • Bile acid sequestrants: These help remove cholesterol from the body, which can rise with T2D.
  • Dopamine-2 agonists: These lower blood sugar following meals.
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors: These help the body make more insulin only when necessary and result in lower elevated blood sugar levels.
  • Meglitinides: People take meglitinides before meals to stimulate the release of insulin.
  • Sodium-glucose cotransporter-2 (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.

Do people with type 2 diabetes ever need insulin?

Some people with T2D may not require insulin. Instead, they may use other medications, such as metformin, to help manage their blood sugars. Some may also manage blood glucose through dietary changes and exercise.

Can people with type 2 diabetes live without insulin?

Yes, people living with T2D can manage their condition effectively without using insulin injections. Instead of insulin, they may use a combination of other medications and lifestyle changes.

What’s the difference between type 1 and type 2 diabetes?

Both T1D and T2D affect the way insulin helps regulate blood sugar levels. With T1D, the body mistakenly attacks the pancreas and prevents it from producing insulin. With T2D, the body still produces insulin, but the cells develop insulin resistance and no longer respond to it correctly. Eventually, the pancreas cannot make enough insulin to meet the body’s needs.

What happens if a person with type 2 diabetes does not take insulin?

If a person with T2D does not follow treatment guidelines, such as taking insulin, their blood sugar levels will rise to excess levels, which doctors call hyperglycemia. Prolonged periods of hyperglycemia will start to damage the body and may result in health complications, such as problems with the heart, eyes, kidneys, and feet.

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. Others 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.

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