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Insulin is used in the management of type 1 diabetes mellitus. It may also be used in type 2 diabetes mellitus when diet and/or oral medications fail to adequately control blood sugar. The choice of insulin preparation (rapid-acting, intermediate-acting, long-acting) depends on the degree of control desired, daily blood glucose fluctuations, and history of previous reactions. Oral agents are used primarily in type 2 diabetes mellitus. Oral agents are used when diet therapy alone fails to control blood glucose or symptoms or when patients are not amenable to using insulin. Some oral agents may be used with insulin.