[dkirkman]

The precision of the timing and dosing depends a lot on what kind of diabetic you are. A type 1 with no endogenous production is going to need precision, and I can't imagine somebody wanting tight control giving up their pump and going with a pill!

type-2's on the other hand, have insulin resistance often accompanied by astonishingly high endogenous production. They can sometimes achieve nice control by just having a base of exogenous insulin that's just high enough for their pancreas to supply the rest of what they need -- the precision is supplied by the still largely functioning pancreas. I know at least one type-2 that has been put on insulin with instructions to inject X units with dinner, with no consideration of the actual content of the meal! Presumably a pill would work fine for that group.

[rhizome]

Doesn't Type 2 already have pill-based treatments?

[dkirkman]

Yes, there are pills that will both increase insulin sensitivity (metformin), and to stimulate insulin secretion (the sulfonylureas). These are basically the first line of treatment. But the disease tends to progress to the point where they are no longer enough. The insulin resistance keeps increasing, and at some point insulin secretion also starts to fall off -- though it's usually still very high compared to a non-diabetic. At that point, exogenous insulin is all that's left. Unfortunately, it also seems to be used as a bit of a threat by MDs ("you'd better loose weight and start exercising, or you're going to need injections!")

BTW, I'm not an MD, just a somewhat informed layman. I just happen to be married to a type-1, and have type-2 running through my family, so I've been motivated to learn a bit about it all (mainly in an attempt at self-preservation!)