Diabetes has been with me for 5 years, I have always adhered to the treatment and arranged exercise and diet reasonably, and my blood sugar has been well controlled, but in the last two months, my blood sugar has fluctuated significantly. However, in the last two months, my blood sugar has been fluctuating significantly. Some of my friends around me are injecting insulin and their blood sugar is well controlled. Should I switch to insulin too? There are strict clinical indications for whether a diabetic patient should use insulin. It is recommended that Mr. Hai go to a specialist hospital as soon as possible and follow the medical advice to adjust his medication. In clinical treatment, the following groups of people need to use insulin. The cause of type 1 diabetes is the lack of pancreatic islet secretion function, and there are almost no islet cells with secretion function in the patient’s body. Type 2 diabetic patients who have failed oral hypoglycemic drugs may experience secondary failure after taking oral hypoglycemic drugs for a period of time, and insulin should also be used at this time. Secondary failure of oral hypoglycemic drugs generally refers to insulin stimulants, including sulfonylureas and clofentezanide. Sulfonylureas, such as euglycemia, damacell, glucophage, etc., should be considered for insulin if they are not effective in controlling blood sugar when used to the maximum amount. However, experts now advocate that insulin should be used as early as possible, with the aim of protecting the function of residual islet cells. When diabetic patients have more serious complications or other serious diseases, they should be treated with insulin. For example, insulin treatment should be used when a diabetic patient develops renal insufficiency, or when diabetic eye disease is severe, and when some other endocrine diseases cause secondary diabetes. When a diabetic patient is under stress, such as severe infection (pneumonia, etc.), fracture, acute myocardial infarction, cerebrovascular accident, etc., the secretion of glucagon will increase significantly, and the original treatment plan will not be able to control blood sugar effectively. Therefore, when in a stressful state, patients need to be treated with insulin. When this phase has passed and glucagon hormone is no longer elevated, insulin can be stopped and the previous oral hypoglycemic drugs can be used again. Pregnant women with gestational diabetes who develop diabetes during pregnancy should be treated with insulin. Diabetes during pregnancy is associated with a high rate of fetal malformations and increased perinatal mortality. Maternal metabolic disorders and hypoxia, especially poor glycemic control in the first 7 weeks of pregnancy, can lead to a variety of fetal malformations, common in the skeletal system, cardiovascular and central nervous system, and a significantly higher incidence of giant babies. High maternal blood glucose also increases perinatal mortality, mostly occurring from 36 to 38 weeks of pregnancy, and its main causes are congenital malformations, intrauterine hypoxia, and birth injuries. Therefore, it is important for pregnant women to control their blood sugar effectively. Since oral hypoglycemic drugs can cause hypoglycemia in the fetus through the placenta, which has the risk of triggering stillbirth, they should be treated with insulin. Insulin cannot pass through the placenta and only lowers the maternal blood sugar, which has no effect on the fetus.