The pancreas doesn't make insulin in type I diabetes. The beta cells are destroyed, when the immune system attacks the pancreas. The diabetic then needs insulin shots to use glucose they receive from the meals they eat. For these patients insulin shots are the only way to keep their blood sugar levels down. This condition can be inherited. Type 1 diabetes is thought to occur when something in a person's environment such as a toxin or a virus triggers it. Type 1 diabetes can happen together with other autoimmune diseases such as hyperthyroidism or vitiligo. . Controlling the diet in type 1 diabetes is very important. The patient must focus on balancing food intake with insulin intake and energy exertion. Lack of insulin production by the pancreas can make type 1 diabetes difficult to control. Treatment requires a commitment to a regimented and calculated diet, planned physical activity, blood glucose testing at home and several daily insulin injections. People with type 2 diabetes make insulin, but their bodies don't respond all that well to it. They don't make quite enough insulin, and the cells of their bodies don't seem to take in glucose as eagerly as they should. Some people with type 2 diabetes need pills or insulin shots to help their bodies use glucose for energy. A family history of Type II diabetes,poly-cystic ovary disease, high blood pressure, being overweight, physical inactivity, history of vascular disease (heart attack, stroke for example), high cholesterol and triglyceride levels, previous gestational diabetes, diagnosed metabolic syndrome and your race and ethnic background may all play roles. Treatment includes diet control, exercise, home blood glucose testing, and in some cases, oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.