Type 2 diabetics often progress to insulin treatment as their pancreas becomes exhausted and ceases proper function.<p>The low insulin sensitivity in type 2 means the pancreas produces large amounts of insulin in a futile attempt to reduce blood sugar.  Initial treatments focus on insulin sensitizing agents to try and assist the natural insulin to be effective.  Despite the amazing capabilities of the body, it eventually becomes too much and people have to start insulin replacement therapy at that point.