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Diabetes Treatment Landscape

Managing diabetes involves both working with patient to select the appropriate therapy and determining how it is delivered.

This page provides a high-level overview of insulin delivery approaches and glucose-lowering therapies to help clinicians understand available options and when they may be considered. The appropriate approach depends on individual patient needs, preferences, clinical goals and access.

SECTION 1: Insulin Delivery Options: Insulin can be delivered in several ways, ranging from manual injections to automated systems.

What it is: Insulin delivered via syringes or pens through subcutaneous injection or inhaled

When it’s typically considered:

  • Initiating insulin therapy in many care settings
  • Situations where simplicity, familiarity, or cost are key considerations
  • Patients who prefer or are comfortable with injection-based delivery

Key considerations:

  • May require multiple daily injections
  • Limited dosing support or automation

What it is:
Insulin pens with digital dose tracking and app integration

When it’s typically considered:

  • Patients using multiple daily injections who may benefit from dose tracking or reminders
  • Individuals who want greater visibility into insulin dosing data
  • Situations where additional support is desired without transitioning to pump therapy

Key considerations:

  • Requires use of a compatible app and ongoing user engagement
  • Data accuracy depends on consistent use

What it is: Devices worn on the body that deliver insulin without multiple daily injections (e.g., patch pumps, bolus patches)

When it’s typically considered:

  • Patients seeking to reduce the frequency of injections or simplify delivery routines
  • Individuals interested in more discreet or wearable delivery options

Key considerations:

  • Requires wearing a device on the body
  • Adhesion, comfort, and device management may vary
  • Features differ across devices 

What it is: Programmable insulin delivery via a wearable pump providing continuous subcutaneous infusion

When it’s typically considered:

  • Patients requiring intensive insulin therapy
  • Individuals needing flexible basal and bolus adjustments
  • Situations requiring more precise or adjustable insulin dosing

Key considerations:

  • Requires training and ongoing management
  • Device wear and troubleshooting required

What it is: Systems that integrate insulin pumps, continuous glucose monitoring (CGM), and algorithms to adjust insulin delivery

When it’s typically considered:

  • Patients using intensive insulin therapy who want increased automation support
  • Individuals seeking support with glucose management, including time in range

Key considerations:

  • Requires compatible devices and system setup
  • User interaction is still required (e.g., mealtime input)
  • Training and ongoing engagement needed

 


SECTION 2: Glucose-Lowering Therapies (Medicines). In addition to how therapy is delivered, treatment decisions also involve selecting the appropriate medication.
 

What it is: Hormone therapy used to lower blood glucose, available in multiple formulations (e.g., rapid-acting, basal)

When it’s typically considered:

  • Patients with type 1 diabetes
  • Patients with type 2 diabetes who require additional glucose lowering
  • Situations where other therapies are insufficient to meet glycemic goals

Key considerations:

  • Requires appropriate dosing and adjustment
  • Risk of hypoglycemia
  • Delivery method (e.g., injection, inhalation, pump) must be selected

What it is: Rapid-acting insulin delivered via oral inhalation using a handheld device

When it’s typically considered:

  • Patients requiring mealtime insulin who prefer to avoid injections
  • Situations where rapid onset of action is desired

Key considerations:

  • Requires pulmonary function assessment prior to initiation
  • Not appropriate for patients with chronic lung disease or certain respiratory conditions
  • Dosing options may be more limited compared to injectable insulin

What it is: Glucose-lowering medications used alone or alongside insulin (e.g., GLP-1 receptor agonists, SGLT2 inhibitors)

When it’s typically considered:

  • Patients with type 2 diabetes requiring additional glucose control
  • Situations where weight, cardiovascular, or renal considerations influence therapy selection
  • As part of combination therapy with insulin or other agents

Key considerations:

  • Mechanism of action and effects vary by class
  • May offer benefits beyond glucose lowering
  • Cost, access, and tolerability vary

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DISCLAIMERS: 

This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit the ADCES finder tool.

ADCES and danatech curate product specifics and periodically review them for accuracy and relevance. As a result, the information may or may not be the most recent. We recommend visiting the manufacturer's website for the latest details if you have any questions.

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