In my case, which may not be typical, I started out taking pills, then had to gradually start taking shots twice a day. This was because I did not watch my diet like I was supposed to. One day I decided I would try to lose weight and exercise...I started eating 6 times a day....breakfast, snack, lunch, snack, dinner, snack...I tried to watch my calorie intake and would try to do at least a half hour of walking every day. As I started losing weight, I added more exercise. My sugar levels started dropping, which allowed me to decrease my insulin...eventually I was able to stop my insulin and kept my sugar under control with just the diet and exercise. I believe that it can be done in most cases. Losing that weight would def finitely be beneficiary. Unfortunately, I did not keep up with eating healthy and gained the weight back so I am back on insulin again. I am now trying to get back the ambition that I once had for my health. I hope this helps!