Type 2 diabetes medications offer many options to manage your blood sugar (also known as blood glucose). But if your current treatment isn’t getting the job done or doesn’t feel right for you, talk to your doctor. She may tell you it’s time to change your treatment plan.
High Blood Sugar
It’s important to keep your blood sugar within a healthy range. This lowers your chances of diabetes complications. If your readings are too high on your current medication, your doctor might want to change the dose or try another.
This can happen even if your medication worked very well at first. Sometimes it just doesn’t do the trick by itself anymore.
If one drug doesn’t manage your blood sugar well enough, your doctor might add a second. If two don’t work, she could add a third.
Low Blood Sugar
Some diabetes medications can make your blood glucose go too low. Your doctor will call this hypoglycemia. It can be dangerous. You might see it with:
- Sulfonylureas like glimepiride (Amaryl), glyburide (Diabeta, Micronase), glipizide (Glucotrol, Glucotrol XL)
- Meglitinides like nateglinide (Starlix) and repaglinide (Prandin)
Your blood sugar might also go too low if you take combination treatments that have these drugs in them:
Talk to your doctor if you have low readings. You might need a lower dose or different medication.
Manage Side Effects
Some are temporary and should go away within a few weeks after you start the drug. Upset stomach, gas, or diarrhea can happen with:
- DPP-4 inhibitors like linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
- Alpha-glucosidase inhibitors like acarbose (Precose) and miglitol (Glyset)
- GLP-1 agonists like albiglutide (Tanzeum), dulaglutide (Trulicity), exenatide (Byetta), exenatide extended release (Bydureon), and liraglutide (Saxenda, Victoza)
- Metformin (Fortamet, Glucophage, Glumetza, Riomet)
You might have the same problem with treatments that combine these drugs. Talk to your doctor if your side effects are severe or don’t go away in a few weeks.
Drugs called SGLT2-inhibitors — canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance) — have a different set of side effects:
- Have to pee a lot
- Yeast infections in women
- Low blood pressure
Some side effects are more serious. If you take pioglitazone (Actos) or a combination drug with pioglitazone in it (Actoplus Met, Duetact), call your doctor if you have:
- Loss of appetite
- Shortness of breath
- Severe swelling
- Dark pee
It’s rare, but metformin can cause a serious condition called lactic acidosis. It can come on suddenly. Get medical help right away if you are on the drug or a combination that contains it, and if you have any of the following symptoms:
- Loss of appetite
- Abdominal discomfort or diarrhea
- Muscle cramping
- Fast, shallow breathing
- Weakness or unusual tiredness
If you’ve made lifestyle changes like weight loss and regular exercise, you might need a lower dose. Your doctor will review your treatment plan and make any needed changes.
Talk to your doctor before you change or stop any medication. Do not quit taking any mediation without her OK.
New Conditions or Medications
If you need to start treatment for something besides diabetes, your doctor might want you to change your medications. Things that can affect your diabetes treatment plan include:
- Kidney disease or dialysis
- Liver disease
- Heart failure
- Heavy drinking
Diabetes medications can affect the way medications for other conditions work. You might need to change your treatment plan if the doctor tells you that you need:
- HIV/AIDS medications
- Pills to help you get rid of extra water (diuretics)
- Angina pills (nitrates)
- Drugs for high blood pressure in your lungs like bosentan (Tracleer)