Do only people with type 1 diabetes take insulin?

This is a very commonly asked and extremely important question. The answer is clear and simple: No. But a lot of people have the misconception that insulin treatment equals type 1 diabetes. 

Type 1 diabetes doesn't mean that you have to take insulin, it means that your body makes very little insulin. All people who have type 1 diabetes have to take insulin. But many people with type 2 diabetes need to take insulin as well. Most people with type 2 diabetes still make a lot of their own insulin, but it's not enough to keep their blood glucose levels in the normal range. Medications other than insulin will help their bodies make more insulin or respond better to the insulin that they are making, but often they are not able to make enough insulin to meet their needs even with these other medications. When this happens, they need to go onto insulin therapy, but they still have type 2 diabetes because they are still making a lot of their own insulin. 

It's important also to remember that insulin must be used in a person who has type 2 diabetes when other medications have  failed, but there are many, many times that insulin should be used much earlier in the course of the disorder simply because it may be a more effective treatment. Over 20 years of caring for people with diabetes I have started hundreds of people with type 2 diabetes on insulin, and I have never made the decision to go to insulin "because  everything else has failed." I have always made the decision because I thought it was the best treatment for the person. A simple example of this might be someone whom I thought could have adequate blood sugar control taking 5 different non-insulin medications, but could be equally well-controlled on a single shot of long-acting insulin every day along with one oral medication. The insulin regimen is usually easier, cheaper and has less potential for drug interactions or side effects. And, in my experience, people are usually happier being on insulin with fewer medications rather than having to take many medications, once they understand that insulin therapy is as safe and as easy as any other form of treatment. 

No, type 2 diabetics can also be placed on insulin therapy to manage uncontrolled diabetes depending on the severity of the disease. For example, a type 2 diabetic who is unable to continue to take oral medications (for any reason) can be placed on insulin therapy to control blood glucose (sugar) levels. Another example would be a diabetic who remains uncontrolled and eventually loses the ability to create their own insulin; therefore, he/she would need to be placed on insulin therapy for management of his/her diabetes.