By Jenilee Matz, MPH
For people with diabetes, getting your blood sugar under control takes a lot of trial and error. It’s normal to have blood sugar readings that are too high or too low every once in awhile, especially if you’re sick or didn’t follow your meal plan as directed. But if blood sugar levels are often outside of your goal range, it’s time to head to the doctor and assess what’s going on.
If a healthy diet, regular physical activity and maintaining a healthy weight aren’t enough to keep your blood sugar levels in target range, your doctor may prescribe medication. But sometimes finding the right medicine—or combination of medications—that works best to treat your diabetes takes some trial and error, too. And as your diabetes changes, your doctor may need to switch your medication for better blood sugar control.
Why You Might Need to Switch Medications
Your doctor may change your diabetes medication or adjust your dosage if:
- Your blood sugar is no longer in control. It’s not uncommon for you to need different or additional medication the longer you have diabetes. If you stop responding to a drug, it doesn’t necessarily mean that your diabetes has gotten worse.
- You experience unmanageable side effects. All medications come with the chance of side effects, and diabetes drugs are no exception. When you’re prescribed a new medication, ask your doctor what side effects to watch for. Some medications may cause weight gain or diarrhea, while other drugs increase your risk for serious health issues.
- You plan to get pregnant. If you’re on oral diabetes medicine and want to get pregnant, your doctor will switch your medication. Diabetes pills are less safe to take during pregnancy, so you’ll need to manage your diabetes with diet, exercise and insulin injections.
How to Tell If a Medication Isn’t Working
Always take all medications exactly as prescribed. All diabetes medications are most effective when combined with good nutrition and regular exercise. These healthy habits work with the medication to bring your blood sugar to goal levels.
The best way to tell if your diabetes meds are working is to record all of your daily blood sugar readings. Bring this record with you to each doctor appointment. Your blood sugar levels can help your doctor determine if your diabetes treatment plan—and medication—is working or not. If you notice that your blood sugar levels are all over the place, don’t wait for your next appointment to speak up. See your doctor as soon as your blood sugar levels are regularly outside of goal range. Getting prompt treatment can help you feel better and reduce your risk of dangerous diabetes-related complications, like heart disease, stroke and blindness.
New Medication Options
Your doctor may switch your medication therapy in one of these ways:
- Change your insulin. Types of insulin vary in how quickly they work, for how long they work, and when they peak (meaning when they work the best to lower blood sugar levels). Your doctor may change the type or dose of insulin you use or combine different types of insulin.
- Swap one pill for another. There are a host of oral diabetes medications on the market. Switching medications may be all that’s needed to get your blood sugar on track.
- Take an additional pill. Some people with diabetes need to take two to three drugs to bring their blood sugar to target levels.
- Add insulin to your treatment plan. Eventually, many people with type 2 diabetes will need to take insulin injections along with oral medicine. Some people even stop taking oral medicine altogether later in their illness, and rely solely on insulin injections when their pancreas is not producing as much insulin anymore.
- Add another injectable medication to your drug regimen. Injectable drugs can work with other medications to keep blood sugar levels steady.
When You’re Prescribed a New Medication
When your doctor prescribes you a new medicine, it’s important to understand how much, how often, when and how to take your medication. Never stop taking a drug unless directed by your doctor. It’s also a good idea to ask your doctor or pharmacist the following questions:
- How long will it take the medicine to work? Some drugs work instantly, while others may take days or even weeks to work.
- How will I know if the medication is working? For example, should you assume the medicine is working if daily blood sugar checks are in goal range?
- When should I stop taking my current medication? And when should I start taking my new medicine? You may need to wait for the old medicine to be out of your system before you introduce the new drug. The prescription should state when you should start the new medicine, which you can check on the label.
- What side effects are common? If you experience certain dangerous side effects, your doctor may switch your medication.
- Are there any precautions I should take? For example, is it safe for you to exercise or drink alcohol while on the drug?
Note that it may take several attempts before you find the diabetes medication regimen that works best for you. Stick with it and work closely with your doctor until you find a plan that works.
Jenilee Matz is a medical writer, health educator and triathlete based in Charlotte, N.C.