Diabetes is a condition that causes high blood sugars. Diabetes affects long-term health in many ways. It can affect the heart, kidneys, and vision if it is not well controlled. When pills and other medications are not enough to control diabetes, insulin treatment is the next step. Insulin is usually injected under the skin with a small needle. Injections are needed at least once a day and sometimes multiple times a day (such as after each meal). Sometimes an insulin pump is needed for continuous delivery of insulin into the body.