Many patients with Type 2 diabetes cannot satisfactorily control their blood glucose with pills, meal plans and exercise. In this case glucose control can sometimes be greatly improved by the addition of an intermediate- or long- acting insulin at bedtime. The individual would most typically stay on their oral hypoglycemic agents (pills). This will lower the fasting sugar, and improve the action of the oral agents at the same time. Patients can maintain control of their glucose this way for a long period of time.
In Type 1 diabetes, Metformin or Thiazolidinediones may be used to supplement insulin therapy if the required insulin doses are high (implying the presence of "insulin resistance"). These agents may improve blood glucose control and lessen insulin requirements.