Samuel Grossman, BS Pharm, Pharm.D, CDE Answered 3/31/2015

The recommendation by the American Diabetes Association and the American College of Endocrinology is to take up to 3 non-insulin medications before initiating insulin. However, depending on your average blood sugar levels (called hemoglobin A1c), a decision about what medication to add on should be evaluated. If your hemoglobin A1c is close to goal there may be an opportunity to use an additional non-insulin medication or an oral medication. If your hemoglobin A1c is far from goal sometimes the only therapy to improve blood sugar levels remains insulin. You should consult your provider to what is the best medication regimen to treat your diabetes. I would like to mention an inhaled insulin product recently came on the market in the U.S. and around the world. This option for medication therapy is possible if you are afraid of needles.