When you and your doctor are thinking about the best way to control your blood sugar, you've got a lot of options to choose from. Insulin and other medicines, including shots and pills, can help keep your levels in a healthy range. So which ones are right for you? 

Here are some of the things you and your doctor will consider when you’re deciding on a treatment.

What kind of diabetes you have. Are you type 1 or type 2? That affects which drugs you should take and the dosage you need. People with type 1 need to take insulin to control blood sugar because their bodies don’t make enough of it. On the other hand, some people with type 2 may need insulin, but others can get their blood sugar down with things like a better diet, more exercise, and different types of diabetes drugs.

Your blood sugar levels. If they stay too high for too long, you’re at risk for complications of diabetes, like eye problems or kidney disease. If your blood sugar is above where it should be, your doctor may add another drug to your treatment plan or increase your dose to get you to a healthy range.

How long you’ve had diabetes. If you’ve had the condition for more than 10 years, some diabetes pills may not help you. But if you’ve just been diagnosed, your doctor might not make insulin the first treatment you try. Also, your treatment plan may change over time, because some medications get less effective the longer you take them.

Other health problems. Some conditions you might have along with diabetes can affect how well your drugs control your blood sugar, including:

  • Obesity
  • High blood pressure
  • High cholesterol
  • Heart disease
  • Kidney disease
  • Sleep apnea or other sleep problems
  • Depression

Some medications that treat diabetes also may help you treat other health problems or lower your odds of having them. For example, GLP-1 agonist drugs help you feel fuller longer after you eat. This may help you lose extra pounds if you're overweight.

But diabetes and some of the medications for it may raise or lower your chances of having some types of cancer, including cancer of the liver, pancreas, or colon. Scientists aren’t sure what the link is. But if you have a very high risk for a certain type of cancer, your doctor may think about that before she recommends a treatment.

How active you are. Exercise can lower your blood sugar levels. That’s a good thing, but you need to factor it into your treatment plan. Talk to your doctor about how much you move each day. You may need to change the dosage of some diabetes drugs if you're more active in your daily life or at work.

Do you drink? Alcohol can lower your blood sugar levels for hours, so it affects how well insulin or diabetes pills work. Tell your doctor how much you drink and if you want to be able to sip a beer or cocktail from time to time. You may need to take extra steps to be sure that it doesn’t interfere with your meds.

Fear of needles. If you can’t stand shots, you may be less likely to give yourself shots when you need them, which is key for blood sugar control. So talk to your doctor if you’re afraid of needles or don’t feel confident about injecting yourself.

Some diabetes drugs come in devices that are like pens and are easier to use than syringes and vials of medicine. Your doctor or nurse can show you how to use them. You might also be able to take a type of insulin that you inhale through your nose.

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