Change is unavoidable — and diabetes treatment is no exception. Most people with diabetes need a different medication at some point. What works in the beginning may not work forever. It’s important to understand why and how your treatment might change.
One key reason for a change is that type 2 diabetes is progressive, meaning it can be more difficult to manage with time. This seems to happen faster in younger people and those who gain weight.
When type 2 diabetes is first diagnosed, lifestyle changes are usually recommended: Eat a healthy diet, exercise, and try to lose weight. A study by the Centers for Disease Control and Prevention found that about 11 percent of new patients partially reversed their diabetes through lifestyle changes alone.
If lifestyle changes aren’t enough to control blood sugar, an oral medication is often prescribed. Oral medications work best in people who have had diabetes for less than 10 years. People with fairly high blood sugar when first diagnosed may need insulin instead of or in addition to oral medications.
Sometimes an oral medication may not be as effective for you after several months or years. It’s not always clear why this happens. Oral medications work in different ways, so there are alternatives available to you. If your hemoglobin A1c (a blood test that measures long-term blood sugar control) becomes too high, your doctor may add another oral medication, add insulin, or increase your insulin dose.
Sometimes medication needs to be changed because of other health conditions. For instance, insulin may be temporarily added to help when fighting a serious infection, undergoing surgery, or experiencing a lot of stress. Insulin may be added long term when the pancreas can no longer make insulin, or when it cannot make enough to meet your needs.
How can you tell if your treatment is working? Monitor your blood sugar at home, see your doctor regularly, and tell him or her if you experience changes in your health or symptoms. And no matter which medications you take, eating a healthy diet and staying active will help them work better. That’s one thing that doesn’t change.
“A1C and eAG.” American Diabetes Association. www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/.
“Association of an Intensive Lifestyle Intervention with Remission of Type 2 Diabetes.” E.W. Gregg et al. Journal of the American Medical Association. Vol. 308, pp. 2489–96. www.ncbi.nlm.nih.gov/pubmed/23288372.
“Can Diabetes Pills Help Me?” American Diabetes Association. www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/can-diabetes-pills-help-me.html.
“Defining and Characterizing the Progression of Type 2 Diabetes.” V.A. Fonesca. Diabetes Care. Vol. 32, supplement 2, pp. S151–56. www.ncbi.nlm.nih.gov/pmc/articles/PMC2811457/.
“What About Insulin?” American Diabetes Association. www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/what-about-insulin.html.
“What Are My Options?” American Diabetes Association. www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html.