When someone is diagnosed with type 2 diabetes, one of the biggest decisions they face is how to manage their blood sugar levels. Two of the most common treatments are insulin and metformin.
Both are effective, but they work in different ways, have different side effects, and are usually used at different stages of the disease. Understanding how each one works and what the research says can help people make informed choices with their healthcare provider.
Metformin is usually the first medication prescribed for type 2 diabetes. It is a pill taken by mouth, and it works by helping the body use insulin more effectively. It reduces how much sugar the liver releases into the blood and improves the way muscles absorb sugar.
Metformin doesn’t cause weight gain—in fact, some people lose a little weight—and it has a low risk of causing dangerously low blood sugar levels, also known as hypoglycemia. These benefits make it a favorite starting point for doctors and patients alike.
A large study called the UKPDS (United Kingdom Prospective Diabetes Study) showed that people with type 2 diabetes who took metformin had a lower risk of diabetes-related complications and lived longer compared to those who took other medications.
The study confirmed that metformin is not only safe but also helps protect the heart, which is important because heart disease is a leading cause of death among people with diabetes.
Insulin, on the other hand, is a hormone that is usually injected. While people with type 1 diabetes must take insulin from the beginning, people with type 2 diabetes often don’t need it right away. But as the disease progresses, the body may produce less insulin naturally, and blood sugar levels may become harder to control with pills alone.
In such cases, insulin may be added to the treatment plan. Insulin can lower blood sugar more effectively than any other medication and is very helpful when sugar levels are dangerously high or when other medications no longer work well.
However, insulin therapy has some drawbacks. It can lead to weight gain, and it has a higher risk of causing low blood sugar episodes, which can be dangerous if not managed carefully. It also requires regular injections, which can feel intimidating or inconvenient for some people.
Monitoring blood sugar more frequently is important when using insulin to avoid highs and lows. That said, insulin is a life-saving and powerful tool for many people with type 2 diabetes who need it.
Some research compares starting insulin early versus continuing with pills like metformin. A 2009 study published in Diabetes Care looked at people who started insulin early after diagnosis and found that this could help preserve some of the body’s own insulin production.
However, most guidelines still recommend starting with metformin unless blood sugar levels are extremely high or symptoms are severe.
In real-life care, many people use both medications. For example, someone may continue taking metformin while adding a small dose of insulin to better control their blood sugar. This combination can work well because metformin helps reduce the amount of insulin needed and may reduce the weight gain associated with insulin use.
In summary, metformin is usually the first and safest choice for treating type 2 diabetes. It’s effective, easy to take, and has few serious side effects. Insulin is a stronger medication that is often used later, especially when other treatments stop working or when blood sugar levels are very high.
Both have important roles, and many people eventually use a mix of treatments to keep their diabetes under control. The best choice depends on the person’s health, how their diabetes is progressing, and what works best for their lifestyle.
If you care about diabetes, please read studies about Vitamin D and type 2 diabetes, and what you need to know about avocado and type 2 diabetes.
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