Treatment medications for type 2 diabetes offer many options for managing blood glucose. However, if your current treatment is not working, or if you feel it is not right for you, you can consult your doctor. Your doctor may answer: It’s time to change your treatment plan.
Managing high blood sugar
Keeping your blood sugar within healthy levels reduces the chance of complications from diabetes. If blood glucose levels are too high while taking your current medication, your doctor may recommend changing the dose of your medication or trying another medication.
This can happen even when certain medications work well when you first start taking them. Sometimes this is the case, and a medication that was working suddenly doesn’t work.
If one medication is not controlling your blood sugar well, your doctor may add another medication. If neither medication is working, a third may be added.
Watch for hypoglycemia
Some diabetes medicines can make a person’s blood sugar too low, which doctors call hypoglycemia. Hypoglycemia can be dangerous. Medications that can cause hypoglycemia include the following:
- Sulfonylureas, such as glimepiride, glibenclamide, and glipizide;
- Glinide drugs, such as nateglinide and repaglinide.
Glucose may also be too low with combination therapy containing:
- Glimepiride/pioglitazone;
- Glibenclamide/metformin;
- Metformin/Reglanol.
Consult your doctor if your blood glucose test is very low. Your doctor may recommend reducing the dose of your medication or changing it.
Managing side effects
Some side effects are temporary and usually go away within a few weeks of taking the medication. The following drugs may cause side effects such as upset stomach, flatulence, or diarrhea:
- Dipeptidyl peptidase 4 (DPP-4) inhibitors, such as alogliptin, ligliptin, saxagliptin, and sitagliptin.
- α-glucosidase inhibitors, such as acarbose and miglitol.
- Glucagon-like peptide-1 (GLP-1) agonists, such as albiglutide, dulaglutide, exenatide, exenatide extended-release, liraglutide, lisnatide, and somaglutide.
- Metformin.
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The same problems may occur with combined treatment with these drugs. If the side effects are severe or do not go away in a few weeks, consult your doctor.
Medicines called sodium-glucose co-transporter protein-2 (SGLT2) inhibitors, such as carteglichen, dagliflozin, and engramlizin, have different side effects:
- High urine volume;
- yeast infection in women;
- Low blood pressure.
More serious side effects can occur if you take pioglitazone or a combination drug containing pioglitazone, consult your doctor if you experience any of the following symptoms:
- nausea and retching;
- vomiting;
- Tiredness;
- Loss of appetite;
- Shallow breathing;
- Severe swelling;
- Dark, dark urine.
In rare cases, metformin may cause a serious condition called lactic acidosis, which may appear suddenly. If you are taking metformin or a combination drug containing metformin, seek medical attention as soon as you develop any of the following symptoms:
- Loss of appetite;
- abdominal discomfort or diarrhea;
- Muscle cramps;
- Shallow, rapid breathing;
- Weakness or unusual fatigue.
Lifestyle changes
If lifestyle changes are made, such as weight loss and regular exercise, the dose of medication may need to be reduced. Your doctor will review the treatment plan and make any necessary changes.
Consult your doctor before changing or stopping any medication. Do not stop taking any medication without your doctor’s approval.
Watch for new symptoms or medications
Your doctor may recommend a change in your diabetes medication if you need to start treatment for a health problem other than diabetes. Factors that may affect your diabetes treatment plan include:
- Kidney disease or dialysis;
- liver disease;
- Heart failure;
- Heavy alcohol use;
- Age.
Diabetes medications may affect the way other medications work. Diabetes treatment plans may also need to be adjusted if your doctor tells you that you need to receive the following medications:
- Anti-Human Immunodeficiency Virus (HIV) or AIDS medications;
- Medications to help remove excess water (diuretics);
- Medications for angina pectoris (nitrates);
- Medications to treat high blood pressure in the lungs, such as bosentan.