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so there are times when I urge my patients to consider insulin therapy for the high blood sugar levels especially if the A1C is more than nine so A1C more than 9 indicates poorly controlled diabetes and the high blood sugar increased risk for dehydration tendonitis inflammation of the joint and other issues insulin therapy is the best way to get your blood sugar under control right away however some patients worry that once they start taking insulin they may not be able to go back without insulin and the answer is not true by focusing on lifestyle modification basically improving oneamp;#39;s eating habits and increasing their physical activity Iamp;#39;ve had numerous patients who have managed to come off the insulin completely