In type 2 diabetes, what is a key reason that insulin therapy may become necessary over time?

• A. Beta cell function deteriorates
• B. Insulin resistance decreases
• C. Diet alone suffices
• D. Oral agents always work indefinitely

Answer: (A)

As type 2 diabetes progresses, the beta cells in the pancreas that produce insulin often deteriorate, leading to reduced insulin output. This decline means the body can no longer produce enough insulin to keep blood glucose in the target range, even if insulin resistance is present. When endogenous insulin becomes insufficient, blood glucose remains high despite lifestyle measures and other medications, so adding insulin therapy becomes necessary. The other statements don’t fit the usual progression: insulin resistance tends to persist or worsen, diet alone is rarely enough long-term, and oral agents don’t always work indefinitely because they rely on functional beta cells and ongoing insulin action.