Insulin should be initiated when A1C is ≥7.0% after 2–3 months of dual oral therapy. The preferred regimen for insulin initiation in type 2 diabetes is once-daily basal insulin. In addition to timely initiation, rapid titration of the dose is indispensable for successful insulin therapy.

What blood sugar level requires insulin?

Insulin therapy will often need to be started if the initial fasting plasma glucose is greater than 250 or the HbA1c is greater than 10%.

At what point do Type 2 diabetics need insulin?

"The American Association of Clinical Endocrinologists recommends starting a person with type 2 diabetes on insulin if their A1C is above 9 percent and they have symptoms," said Mazhari. Symptoms of type 2 diabetes include thirst, hunger, frequent urination, and weight loss.