This article discusses seven reasons you might need to change your diabetes medication.
Blood Sugar Is Not Well Controlled
If your current medication isn’t doing a good job of controlling your blood sugar, you might need a change. Your healthcare provider will set targets for your blood sugar levels, but in general, blood sugar should be between 80 and 130 milligrams of sugar to deciliters of blood (mg/dL) and less than 180 mg/dL two hours after eating.
It’s normal to have fluctuations in blood sugar levels throughout the day. However, consistently low or high blood sugar levels can signify that your medication is no longer working.
A blood sugar reading below 70 mg/dL is considered low. Symptoms of low blood sugar—called hypoglycemia—can include:
Increased heart rateTremblingDizzinessHungerConfusionMood swingsSweating
Blood sugar levels above 180 mg/dL are considered high and can cause hyperglycemia. Symptoms of this condition can include:
Increased thirstFrequent urinationBlurry visionHeadacheWeaknessFatigue
Side Effects Are Intolerable
Even if your diabetes medication effectively controls your blood sugar levels, some drugs can sometimes cause intolerable side effects.
Common side effects of diabetes medications include:
GasDiarrheaConstipation
Other side effects can include:
Yeast infectionsUrinary tract infections (UTI)Increased risk of heart failure or heart attackLow sodium levelsBlood pressure changesCoughSore throat
Drinking alcohol with certain diabetes medications can cause nausea and/or vomiting.
Your Lifestyle Changes
Lifestyle changes, such as incorporating regular physical activity, are essential to managing type 2 diabetes. However, exercise also decreases blood sugar levels as muscles pick up sugar from your blood to use for energy. If you start exercising regularly, your diabetes medication might need to be adjusted, especially if the medication helps to lower your blood sugar.
Biguanides Bile acid sequestrants Alpha-glucosidase inhibitors DPP-4 inhibitors Dopamine-2 agonists Thiazolidinediones (TZDs) Sulfonylureas Meglitinides SGLT2 inhibitors
Always check your blood sugar level before physical activity, as exercise could increase your risk of hypoglycemia. Your healthcare provider might adjust your medication or advise you to eat a carbohydrate-heavy snack to help prevent your blood sugar from dropping too low during or after exercise.
Regular physical activity can also lead to weight loss, which might require adjusting your diabetes medications or dosage.
Pregnancy or Postpartum
Pregnant people with diabetes usually have more frequent than normal visits to their healthcare provider. It’s crucial to properly manage blood sugar levels during pregnancy with type 2 diabetes, which might require medication changes. Uncontrolled blood sugar during pregnancy can lead to complications, such as:
Congenital disabilitiesC-section (cesarean section) deliveryBaby grows extra largeHigh blood pressure (hypertension)Preterm labor/birthMiscarriageStillbirth
New Medication Is Available
In some cases, your healthcare provider may decide to change your type 2 diabetes medication when a new one becomes available. Some recent diabetes drugs have been shown to have other health benefits other than controlling blood sugar levels.
For example, sodium-glucose cotransporter-2 (SGLT2) inhibitors can aid in weight loss, lower the risk of cardiovascular (heart) disease, and lower blood pressure.
Examples include:
Steglatro (ertugliflozin)Farxiga (dapagliflozin)Jardiance (empagliflozin)Invokana (canagliflozin)
Glucagon-like peptide-1 (GTP-1) receptor agonists can also aid in weight loss and lower the risk of cardiovascular disease.
Examples include:
Victoza (liraglutide)Ozempic (semaglutide)Trulicity (dulaglutide)
Interaction With Other Medications
Sometimes your healthcare provider will change your type 2 diabetes medication because it interacts with another medication you are already taking. For example, beta-blockers, niacin, thiazides, and glucocorticoids, can have adverse side effects for people with type 2 diabetes, such as decreased sensitivity to insulin and increased blood sugar levels.
Diabetes medications can also interact with herbal supplements, such as:
GinsengAloe veraAndrographis paniculataKarelaSaint-John’s-wortLyciumHerbs that contain glucosamines, isoflavones, or levocarnitine
You Are in Remission
Type 2 diabetes is a condition that can be in remission (temporary recovery). Technically, this condition isn’t “cured” since blood sugar levels can revert to unhealthy levels and diabetes can return.
People with type 2 diabetes are considered to be in remission when blood sugar levels are in a normal range, without medication, for at least three months. Remission can occur from significant lifestyle changes, such as losing weight through healthy lifestyle changes.
Summary
There are many reasons why your healthcare provider might change your type 2 diabetes medication—it isn’t working well, your side effects are intolerable, it interacts with another medication you are taking, or your lifestyle changes significantly.
If your blood sugar levels are well controlled, you might need less medication, or none at all. Talk to your healthcare provider before making any changes to your medication.
A Word From Verywell
Keeping blood sugar levels in a healthy range is important for avoiding serious complications that can occur with type 2 diabetes. Always follow your healthcare provider’s instructions when taking medications. Consider making positive lifestyle changes that can also improve your condition.
