If you've been diagnosed with type 2 diabetes, you've probably been advised to lose weight and start exercising. The right diet and a good exercise plan both help keep your blood sugar where it should be. With that said, eating right and working out aren't always easy for busy people to fit into their schedule.

"If we have the time to eat correctly, exercise and optimize our weight, this would offset a lot of the diabetes," says Louis Amorosa, MD of the Robert Wood Johnson Medical School in New Jersey. "But most of us can't live a therapeutic lifestyle because it's hard to find the time. So even though nutrition and exercise are wonderful treatments for diabetes, they can be almost impossible to follow."

If blood sugars stay elevated, the next treatment is oral medication, Amorosa says. Among the oral medications that lower blood sugar is metformin, which is marketed as Glucophage, he says. "This is usually the starting drug for people who can't control diabetes with diet," Amorosa explains. "It tells the liver not to produce so much sugar. Because there is such a big market now, the drug companies are coming out with more and more drugs."

A whole new tier of medications for those with type 2 diabetes includes the non-insulin injectables such as Byetta (which slows down the digestive process and can stimulate insulin production),  he says.

"These medications mimic the gastrointestinal hormones and augment the action of insulin," Amorosa says. "An advantage is that they are associated with mild weight loss."

If the person's hemoglobin A1c (which is a good way to test how the blood sugar is doing over a couple of months) rises over 8, then insulin might be prescribed. "If all the other modalities have been tried, we consider insulin," Amorosa says.

The downside of giving insulin is that it causes weight gain, explains Dr. Kent Holtorf, who specializes in endocrinology. "Insulin will bring down the blood sugar but it causes the patient to gain weight," he says. "So you're fighting yourself. You gain 30 pounds and you are worse off. So insulin should be looked at as a last ditch effort."

It makes much more sense, he says, to encourage the patient to lose weight. "That's key," Holtorf says. "Because once you put someone on insulin, they are not going to lose weight or reverse their diabetes."

People with type 2 diabetes who are unable to lose weight also should get an extensive thyroid workup, Holtorf says. "What we are finding is that some patients are having trouble losing weight because they have a low thyroid," he explains. "And it may not be detected by the standard blood tests." Medications to treat a low thyroid can help, so it's worth looking into, Holtorf says.