What to Do When Your Diabetes Medication Isn't Working

Due to the progressive nature of diabetes, your medication needs can change over time. Medication regimens are individualized to consider heart and kidney comorbidities, efficacy, hypoglycemia (low blood sugar) risk, impact on weight, cost and access, risk for side effects, and personal preferences.

Sometimes, simple tweaks, such as walking more or taking your medication at a different time, are enough to be effective. Other times another class of diabetes medication may be needed.

This article discusses why your diabetes medication may not work, signs to look out for, and other ways to help manage your diabetes.

Why Medications Stop Working

Medications are prescribed to assist in lowering glucose by different mechanisms, but people with diabetes should not assume that taking medicine alone will keep their blood sugars in their target range forever; diabetes medications should be an adjunct to diet and exercise.

Insulin Resistance

Blood sugar (glucose) may start to rise because your pancreas isn't making enough insulin, your cells are resistant to the insulin you are making, or a combination of both. This can happen due to weight gain, changes in diet and exercise, and age.

Weight gain can cause insulin resistance (your body doesn't properly respond to insulin), increasing blood sugar. Not exercising, being sedentary, and eating excess carbohydrates can also contribute to insulin resistance, increase blood sugar, and put additional stress on the pancreas.

Duration of Diabetes

Having diabetes for a long time is another factor that can contribute to your medication's effectiveness. That's because the longer you have diabetes, the more likely the pancreas is slowing down and not making enough insulin. The progression of diabetes is different from person to person, but it's not unlikely that your medications will change the longer you have the condition.

Not Following Your Treatment Plan

Lastly, medications may stop working if you are not taking them as prescribed, using improper techniques to inject insulin, or taking expired medicines. They also won't work if you don't take them. If your regimen is too complicated, reach out for help. Simplifying your regimen can make diabetes less burdensome.

Signs Medication Isn't Working

If you are experiencing symptoms of hyperglycemia (high blood sugar), such as increased urination, thirst, fatigue, or weight loss, it may indicate that your medication regimen is no longer controlling your glucose levels.

It's important to regularly check your blood sugar levels at home to monitor for any patterns.

When to Talk to Your Healthcare Provider

If you notice a change in your blood sugar that presents as a pattern, it is a good idea to reach out to your healthcare provider. For example, the American Diabetes Association (ADA) suggests that if your hemoglobin A1C (a three-month average of your blood sugar) goes up by 1.5%, you may need to add another medication to your routine.

Other Medication Options

Many medications are used to treat high blood sugar in people with type 2 diabetes, especially as the condition progresses and needs change.

For example, some people who have had diabetes for many years may need insulin to keep blood sugars in a healthy range. This does not mean they've failed their diabetes; rather, their body isn't making the insulin it needs to keep their blood sugar at goal levels. Over time, the disease can overcome the effect of other medications, such as oral medicines and non-insulin injectables.

It is also not uncommon for people newly diagnosed with diabetes, symptoms of hyperglycemia, or evidence of weight loss, to be prescribed intensive medication therapy, like an insulin pen, at diagnosis. Once blood sugars normalize, they may be able to switch to non-insulin medicines.

Lifestyle Changes

No matter where you are in your diabetes journey, lifestyle changes, such as eating a nutritious diet, exercising, and getting adequate sleep, are important for overall health and diabetes management.

Diabetes self-management education provides you with tools to make lifestyle changes to help you achieve your health goals. You can also schedule an appointment with a certified diabetes care and education specialist to help create an individualized care plan that works for you.

Surgery

If diet, lifestyle changes, and medication are unable to help you achieve your diabetes management goals, surgery may be an option. Studies have shown that bariatric surgery (weight loss surgery) can lead to diabetes remission and can reduce the risk of diabetes-related complications.

However, not everyone with type 2 diabetes can or should have bariatric surgery. You and your healthcare provider should discuss whether bariatric surgery is right for you.

Summary

There are many reasons why your diabetes medicines can stop working. Some of these are within your control, such as lifestyle behaviors and when and how you take your medicines, while others, like the duration of diabetes, are not.

If you experience high blood sugar and symptoms such as increased thirst and urination, and your glucose values are repeatedly above target range, reach out to your healthcare provider. They can help you navigate or change your treatment plan to ensure your blood sugar is properly managed.