There are mainly two type of diabetes .
Type 1 diabetes - Which is due to reduced insulin level in the body
Type 2 diabetes - Where the basic defect is not the reduction of insulin but due to reduced action of insulin.
In Type 1 diabetes treatment of choice is only insulin.
In Type 2 diabetes initial treatment of choice is anti diabetic tablets. Insulin is given only in the following situations
(a) Newly diagnosed symptomatic type 2 diabetes with severe hyperglycemia.
(b) Poor glucose control while taking maximal doses of a combination of oral medications.
(c) Intercurrent illness (eg - myocardial infarction, infection) or operation.
(d) Pregnancy.
(e) Kidney disease.
(f) Liver disease.
(g) Allergy to or inability to tolerate oral antidiabetic medication.
