There's no simple way to tell when a patient with type 2 would do best on insulin, says Richard Hellman, MD, former president of the American Association of Clinical Endocrinologists. But there are guidelines.
There are exceptions, of course. Someone who otherwise seems to be a good candidate for insulin may not be able to manage such a regimen if he or she has limited vision and dexterity and no family support.
If you do need insulin in the short- or long-term, your doctor may prescribe one of four different types. These vary by how quickly or slowly they reach the bloodstream (the onset), the amount of time they work at maximum strength (the peak time), and how long they continue to be effective (the duration).
The different types of insulin mimic the natural rhythm of a healthy pancreas, which produces a consistent low level of the hormone and occasional bursts of insulin to cope with postmeal boosts in blood sugar.
Your blood glucose level
What other medicines you take
Your overall health
In type 2 diabetes the body is resistant to insulin. The beta cells in the pancreas churn out insulin as fast as they can to overcome this insulin resistance. This Herculean task can eventually exhaust the beta cells and diminish their ability to produce insulin, potentially resulting in them being unable to produce any insulin at all.