The goal in treating type 2 diabetes is to control blood sugar levels by keeping them in your target range. Lifestyle changes, such as losing weight and being more active, are the first steps to get blood sugar under control. But you may also need to take a diabetes medicine (such as metformin), which helps decrease the body's resistance to insulin and help insulin work better in the body.

Diabetes often gets worse over time. And when it does, diabetes medicines don't work as well. Insulin can help people with type 2 diabetes keep their blood sugar under control. Sometimes your doctor may recommend insulin because of other health problems, such as kidney complications.

Insulin is a hormone that helps sugar enter your cells, where your body uses it for fuel. When your body doesn't make enough insulin or can't use it the way it's supposed to, your blood sugar gets too high. This can be serious or even life-threatening.

Most people use insulin as an injection, or shot. It is given into the fatty tissue just under the skin. Learning how to give yourself insulin may take some time. You'll also need to pay more attention to your blood sugar levels than you may be used to. But with practice, monitoring your levels and using insulin correctly can become a routine part of your day.

Some people can take insulin through an inhaler. Inhaled insulin works very fast, so it is usually taken right before eating. People who have lung problems or trouble breathing cannot take inhaled insulin.

Using insulin has few risks and side effects. You may gain weight, especially if you are already overweight. The biggest risk of insulin use is very low blood sugar (hypoglycemia), which can turn into an emergency if not managed right away.

Using inhaled insulin may reduce how well your lungs work. If you take inhaled insulin, your doctor will test your lungs every 6 to 12 months using a spirometer. This test is done in the doctor's office and is not painful.

About low blood sugar

Some common reasons for very low blood sugar include:

• Taking too much insulin.
• Skipping meals or not eating enough food.
• Exercising without eating enough, or being much more active than usual.
• Drinking too much alcohol (especially on an empty stomach).

By checking your blood sugar levels often, taking insulin on a schedule, and eating regular meals, you can avoid low blood sugar.

It's a good idea to know the signs of low blood sugar, which include feeling tired, weak, or shaky. If your blood sugar drops very low and you don't get help, you could get confused or drowsy or even lose consciousness and possibly die.

Most of the time, you can treat mild—and sometimes moderate—low blood sugar by eating something that contains sugar.

Insulin is the most effective medicine for lowering blood sugar levels. Keeping blood sugar under control reduces your risk for other health problems caused by diabetes, such as eye problems, kidney disease, and nerve damage.

If your blood sugar can't be controlled even if you lose weight and take other medicine for diabetes, your doctor is likely to recommend taking insulin.