Why Your Type 2 Diabetes May Require More Medication at Times
Your doctor wants to add a new medicine to your regimen. Are you doing something wrong?
Right after a diagnosis of type 2 diabetes, your doctor will likely suggest a treatment regimen. This may or may not include medication. (It depends on where you are in your diabetes progression.) Over time, your doctor may tweak your treatment to meet your evolving needs. This may include changing or adding a diabetes medication.
You might feel like this is a “failure,” or that it’s your fault that you need another medicine. However, diabetes progression is complex and involves a number of factors. It’s not uncommon for diabetes to progress over time, despite your best efforts.
Diabetes medication to meet your target glucose levels
One of the goals of medications for diabetes is to help you maintain healthy and stable blood glucose levels. Too low, and you may not be getting the energy you need. Too high, and your body may sustain damage over time. High blood sugar levels increase the risk of diabetes complications, such as heart problems and kidney damage.
If you’re not able to maintain healthy blood sugar levels with your current treatment plan, your doctor may add or change medications. Your doctor may also prescribe different or additional treatment if certain scenarios make it hard to control your blood sugar. Examples include if you:
Are taking other medicines that affect your blood sugar levels
Have an infection
Are pregnant
Are hospitalized
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Oral medicines
When lifestyle changes alone cannot manage blood sugar, your doctor may prescribe an oral diabetes medication. There are several types, and they work in different ways. Some examples include medicines that:
Decrease the amount of glucose that the liver produces
Help the body produce more insulin (which helps control blood sugar)
Allow the body to secrete extra glucose through urine
Make the body more sensitive to insulin
Your doctor may prescribe one of these medicines, but you may need more than one as time goes on. You might also switch types sometimes to find the right fit.
Insulin therapy
Your doctor may prescribe insulin therapy if your glucose levels are not in the target range with oral medicines. This is especially true if you are taking multiple oral medications and still not getting good blood sugar control.
When using insulin therapy, you will need to inject insulin under the skin. It is not available as an oral pill. There are different types of insulin: Some act quickly and for a short time, while others may take longer to reach the bloodstream but are effective for a longer period. You can also get insulin at different strengths.
Non-diabetes medicines
As your diabetes progresses, you may need other medicines that help other parts of the body. For example, type 2 diabetes can have serious effects on the heart and blood vessels. As a result, people with type 2 diabetes have an increased risk of heart disease, heart attack, and stroke. To manage these risks, your doctor may prescribe medicines that help lower blood pressure (such as ACE inhibitors) or help lower cholesterol (such as statins). Your doctor will make these decisions based on your personal risk factors for different diabetes complications.
Talking to your doctor about treatment
Treating a lifelong condition like type 2 diabetes can be overwhelming. It’s easy to feel intimidated by the instructions and advice. Be open and honest with your doctor when you have questions and concerns. This can help them tailor the treatment so you can have the most successful outcomes.
- Tara Kim, MDTara Kim, MD, is an endocrinologist at Lenox Hill Hospital, Northwell Health.
References
American Diabetes Association. (n.d.). Insulin & other injectables: insulin basics.
American Diabetes Association. (n.d.). Medication & treatments: get a handle on diabetes medication.