Excellent control is rarely achieved, but the ease of use and lesser concern about overall life expectancy may outweigh the theoretical risks. This issue is always best decided by the physician and patient considering all the individual factors involved. Chlorpropamide, tolazimide, tolbutamide, and gliburide are examples of such drugs. Some physicians avoid these drugs altogether. Insulin is the main means of controlling diabetes which is not responding to diet, and is the necessary treatment for type I disease.
Various types are available, varying in their peak onset of action, duration, etc.
Often, two types are given in combination. Insulin is given by the patient as an injection under the skin using disposable very small needles and syringes, after appropriate training. Although the prospect seems drastic at first, diabetics quickly accept this as a routine part of their regimen. In the initial phase, many adjustments are necessary, sometimes in the hospital, until the right doses are determined. Modern medicine stresses the importance of near-normal blood sugars in the prevention of complications of diabetes.