In some cases, people with type 2 diabetes need insulin injections to manage their blood sugar levels. For others, type 2 diabetes can be managed without insulin. Depending on your health history, your doctor might recommend that you manage type 2 diabetes through a combination of lifestyle changes, oral medications, or other treatments.

Here are six things you need to know about managing type 2 diabetes without insulin.

Some people with type 2 diabetes can control their blood sugar with lifestyle changes alone. But even if you do need medication, healthy lifestyle choices are important.

To help manage your blood sugar levels, try to:

  • eat a well-balanced diet
  • get at least 30 minutes of aerobic exercise per day, five days per week
  • complete at least two sessions of muscle-strengthening activities per week
  • get enough sleep

Depending on your current weight and height, your doctor might encourage you to lose weight. Your doctor or dietitian can help you develop a safe and effective weight loss plan.

To lower your risk of complications from type 2 diabetes, it’s also important to avoid tobacco. If you smoke, your doctor can recommend resources to help you quit.

In addition to lifestyle changes, your doctor might prescribe oral medications for type 2 diabetes. They can help lower your blood sugar levels.

Many different classes of oral medication are available to treat type 2 diabetes, including:

  • alpha-glucosidase inhibitors
  • biguanides
  • bile acid sequestrants
  • dopamine-2 agonists
  • DPP-4 inhibitors
  • meglitinides
  • SGLT2 inhibitors
  • sulfonylureas
  • TZDs

In some cases, you might need a combination of oral medications. This is known as oral combination therapy. You might need to try several types of medication to find a regimen that works for you.

Insulin isn’t the only type of injectable medication used to treat type 2 diabetes. In some cases, your doctor might prescribe other injectable medications.

For example, medications such as GLP-1 receptor agonists and amylin analogues need to be injected. These types of medications both work to keep your blood glucose levels within a normal range, particularly after meals.

Depending on the specific medication, you might need to inject it daily or weekly. If your doctor prescribes an injectable medication, ask them when and how to take it. They can help you learn how to safely inject the medication and dispose of used needles.

If your body mass index — a measure of weight and height — meets the criteria for obesity, your doctor might recommend weight loss surgery to help treat type 2 diabetes. This procedure is also known as metabolic or bariatric surgery. It can help improve your blood sugar levels and lower your risk of diabetic complications.

In a joint statement issued in 2016, multiple diabetes organizations recommended weight loss surgery to treat type 2 diabetes in people with a BMI of 40 or higher. They also recommended weight loss surgery for people who have a BMI of 35 to 39 and a history of unsuccessfully trying to manage their blood sugar with lifestyle and medications.

Your doctor can help you learn if weight loss surgery is an option for you.

Different types of medication, surgery, and other treatments can cause side effects. The type and risk of side effects varies, from one treatment to another.

Before you start taking a new medication, talk to your doctor about the potential benefits and risks of using it. Ask them if it can interact with any other medications or supplements that you take. You should also let your doctor know if you’re pregnant or breastfeeding, since some medications aren’t safe for pregnant or breastfeeding people to use.

Surgery can also put you at risk of side effects, such as infection at an incision site. Before you undergo any operation, ask your doctor about the potential benefits and risks. Talk to them about the recovery process, including steps you can take to reduce your risk of postsurgery complications.

If you suspect that you’ve developed side effects from treatment, contact your doctor. They can help pinpoint the cause of your symptoms. In some cases, they might adjust your treatment plan to help relieve or prevent side effects.

Over time, your condition and treatment needs can change. If you’ve found it difficult to manage your blood sugar with lifestyle changes and other medications, your doctor might prescribe insulin. Following their recommended treatment plan can help you manage your condition and lower your risk of complications.

Many treatments are available for type 2 diabetes. If you have questions or concerns about your current treatment plan, speak with your doctor. They can help you understand your options and develop a plan that works for you.