Oral medications are effective at lowering blood sugar when diet and exercise alone aren’t enough to manage type 2 diabetes. However, oral medications aren’t perfect, and they don’t always work in the long term. Even if you’ve been taking your diabetes medication as your doctor prescribed, you might not feel as healthy as you should.
Diabetes drugs can and do stop working. About 5-10% of people with type 2 diabetes stop responding to their medication every year. If your oral diabetes medication is no longer working, you need to find out what’s preventing it from controlling your blood sugar before you explore other options.
When your oral diabetes drug stops working, schedule an appointment with your doctor. Your doctor will want to know if anything in your routine has changed.
Many factors affect how your medication works. For example, weight gain, changes in your diet or activity level, or a recent illness may cause your medication to become less effective. Making changes to your diet or exercising more each day may get your blood sugar under control again.
It’s also possible that your diabetes has progressed. The beta cells in your pancreas that produce insulin can become less efficient over time. This can leave you with less insulin and poorer blood sugar control.
Your doctor may not always be able to find out why your medication stopped working. If the drug you’ve been taking is no longer effective, consider looking at other medications.
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Metformin is often the first drug you’ll be prescribed to control type 2 diabetes. If metformin stops working, another step could be to add a second oral drug.
You might need more than one additional medication to achieve good blood sugar control. Some pills combine two diabetes medications in one, such as glipizide and metformin, and saxagliptin and metformin. Taking one pill makes for easier dosing and reduces the chance that you’ll forget your medication.
Another option is to add insulin to your oral diabetes drug or switch to insulin. Your doctor may recommend insulin therapy if your A1C level is very far from your goal or you have symptoms of high blood sugar, such as thirst or fatigue. Your A1C level shows your blood sugar control over the last two to three months.
Taking insulin can give your pancreas a break. Insulin can help manage your blood sugar quickly and may help you feel better.
Increasing your insulin dose may help you control your blood sugar.
If you are overweight, excess fat makes your body more resistant to the effects of insulin. You may need to take extra injections of short-or-rapid acting insulin every day to get your blood sugar within a healthy range.
Insulin comes in several forms, classified by how quickly they work, their peak time, and how long it lasts. Rapid-acting insulin starts working quickly after a meal and usually lasts around two to four hours. Long-acting insulin medications are typically taken once a day and used to control blood sugar between meals or overnight.
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Switching to a new medication won’t necessarily immediately correct your blood sugar levels. You may need to tweak your dosage or try several different drugs before you get control over your diabetes.
Try to see your doctor about once every three months to go over your blood sugar and A1C levels. Visits with your doctor will help determine if your oral medication is controlling your blood sugar. If not, you’ll need to add another drug to your treatment or switch medications.
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