In type 2 diabetes, the body fails to properly use insulin, which is needed to take sugar from the blood to the cells (where it belongs). But for glucose to pass into a cell, insulin must be present and the cell must be "hungry" for glucose. Therefore, either the body does not produce enough insulin, or the cells ignore the insulin

Hypoglycemia, or low blood sugar, can happen even during those times when you're doing all you can to control your diabetes. Hyperglycemia, or high blood sugar, is a major cause of many of the complications that happen to people who have diabetes. Keeping your blood sugar as close to normal as possible helps you feel better and reduces the risk of long-term complications of diabetes. The first treatment for type 2 diabetes is often meal planning for blood sugar control, weight loss, and exercising. Sometimes these measures are not enough to bring blood sugar down near the normal range. The next step is taking a medicine that lowers blood glucose levels. Diabetes sometimes damages kidneys so badly that they no longer work. When kidneys fail, one option is a kidney transplant.

All diabetes medications sold today in the United States are members of five classes of drugs, which work in different ways to lower blood glucose levels:

1. Sulfonylureas
2. Meglitinides
3. Biguanides
4. Thiazolidinediones
5. Alpha-glucosidase inhibitors
   

Diabetes pills only work for people whose pancreas still makes some insulin, so they can not help people with type 1 diabetes. When oral medication fails then you can use insulin or an insulin pump to help manage your diabetes