With the rapid development of China’s economy, people’s lifestyles and dietary structure change, the incidence of diabetes, especially type 2 diabetes, continues to rise. At the same time, with the improvement of the medical level, the means of diabetes treatment are gradually improved. Unlike type 1 diabetes, where the only treatment modality is the lifelong replacement use of insulin, type 2 diabetes is treated with a variety of combinations of modalities, and the choice of individualized glucose-lowering modalities is particularly important for patients. The choice of individualized glucose-lowering modalities is particularly important for patients. Due to the specificity of the patients themselves, such as whether they are predominantly insulin resistant or insulin deficient, whether they have elevated fasting glucose or elevated postprandial glucose, whether they are obese or lean, etc., all of these will influence the choice of treatment modalities by the physicians. In the current treatment of type 2 diabetes, patients usually take oral medication first, and insulin is used only when it cannot be controlled. However, in some cases, patients are immediately diagnosed with type 2 diabetes and are treated with insulin. Many patients do not understand and accept this. So what do doctors consider when choosing treatment for their patients? Why do doctors put some patients on insulin treatment right after they are diagnosed with diabetes? Which patients usually need this? What are the benefits? For diabetic patients with high blood glucose level at diagnosis, doctors let them treat with insulin as soon as they are diagnosed because insulin can control high blood glucose more effectively, eliminate high glucose toxicity as soon as possible, improve pancreatic beta cell dysfunction caused by high blood glucose, and enable some patients to control blood glucose well by adopting lifestyle alone. How long does it usually take? What level of blood glucose should be reached? As for patients with higher blood glucose with first-onset type 2 diabetes, there is individual variability in the duration of intensive insulin therapy due to individual differences in insulin sensitivity, and generally patients can bring their blood glucose under control in about 1 week to 2 weeks. For general patients, under the condition of trying to avoid the occurrence of hypoglycemia, the target of blood glucose control: fasting 3.9-7.2 mmol/L, non-fasting ≤10.0 mmol/L, or HbA1c <7.0% can be considered well controlled. However, in the elderly, especially in elderly patients with pre-existing high-risk cardiovascular and cerebrovascular risks, hypoglycemia can induce cardiovascular and cerebrovascular events and even lead to death. Therefore, the focus in treatment is to avoid the occurrence of hypoglycemia, rather than intensive treatment to control blood glucose. The goal of blood glucose control should follow the principle of individualization, which can be slightly wider than that of general adults. Can I stop or change to oral medication later if I am treated with insulin at the beginning like this? After controlling blood glucose with intensive insulin therapy, relevant laboratory tests need to be performed to evaluate the patient's beta cell function. If the patient's beta cell function is good, it is possible to change to oral medication or medical nutrition therapy and exercise therapy. However, if the patient's beta-cell function has been significantly reduced, generally speaking, it is necessary to continue insulin therapy if the change to other treatment methods is not satisfactory for blood sugar control.