The goal of diabetes treatment remains the same for each person—bringing blood glucose down to target levels and preventing complications. But no one pill or injection works for everyone. Some people can manage their conditions with diet and exercise, while others must inject insulin or take oral diabetes medications.With your help, your doctor will develop a personalized treatment plan. The plan should control your condition while fitting as easily as possible into your daily life. Sharing information about your health, your preferences, and your lifestyle can help you both make the best decisions about therapy. 

When choosing between treatments, your doctor will consider: 

1. Your Diabetes Type

If you have type 1 diabetes, your pancreas no longer produces the insulin your body needs to convert sugar to energy. So, you will need insulin shots to process the glucose from your meals. 

In type 2 diabetes, your body produces insulin but can’t use it properly. Sometimes, insulin shots still help. But in many cases, diet, exercise, and oral medications work better to control your blood glucose. In some cases, taking diabetes pills at the same time helps the body use the insulin from shots better, or you may take more than one type of medicine—this approach is called combination therapy.

2. Your Blood Glucose

High blood glucose leads to the complications of diabetes, such as eye, nerve, kidney, and heart disease. If you have extremely high levels, your doctor may combine insulin shots and medications—potentially more than one—in addition to diet and exercise.

3. Your Diagnosis Timeline

If you have type 2 diabetes, your doctor may first recommend making changes to your eating habits and increasing the amount of time you exercise. If that doesn’t work to control your blood glucose, the next step is usually trying diabetes medicines. In most cases, these pills work best for people who have had diabetes for less than 10 years.

4. Your Pregnancy Plans

Tell your doctor if you plan to become pregnant. In general, oral diabetes medications aren’t safe for developing babies, so you may have to manage your condition with diet, exercise, and insulin instead.

5. Your Exercise Habits

Physical activity helps control your blood glucose levels—in fact, it’s an important part of most diabetes treatment plans. However, your blood glucose levels can temporarily dip too low immediately after exercise, especially if you have type 1 diabetes. Your doctor may change the type and dose of insulin or other medications you take based on your workout schedule. Share the details of your routine.

6. our Finances

Costs vary widely between types of diabetes treatments. Talk with your doctor if you have concerns about paying for your medicines or injections. Often, generic versions of common medications cost less and have the same effects. 

7. The Other Medicines You Take

When you take pills or injections for diabetes, they mix with all the other drugs in your system. Sometimes this causes changes you—or your doctor—don’t want. For instance, your birth control medications might not work as well, or your blood glucose may drop too low.

Tell your doctor about all the medicines you take, including prescription and over-the-counter drugs as well as herbal remedies and vitamins. You may find it helpful to write them all down and keep a list with you, or use an online service to track them (some also warn you of potentially dangerous interactions).

8. Whether You Already Have Diabetes Complications

All diabetes treatment aims to prevent complications by lowering your blood glucose, but some diabetes medications also act directly on certain organs and systems to improve your health. For instance, a medicine called pioglitazone (Actos) appears to treat and prevent damage to your kidneys as well as controlling your blood glucose.

In other cases, though, diabetes medicines can worsen complications or require your doctor to monitor you more closely. People with existing kidney disease risk a rare but life-threatening condition called lactic acidosis when they take many diabetes drugs. Your doctor may educate you on the symptoms of lactic acidosis (including severe diarrhea and vomiting) so you can seek help quickly if necessary.