If you have type 2 diabetes, the most common type of diabetes, it’s important to manage the condition. Uncontrolled blood sugar increases your risk of developing serious and even life-threatening health problems such as heart disease, nerve problems, and kidney damage.
Diabetes medication is usually prescribed when diet and exercise alone don’t control blood sugar levels. But some medications may cause negative side effects or may not manage your blood sugar effectively. It’s a good idea to take inventory of your diabetes treatment plan now and then to make sure it’s working well.
The goals of diabetes treatment and medications
According to the Diabetes Treatment Center at the University of California, San Francisco, the two main goals of diabetes treatment are:
- to keep blood sugar levels as stable as possible without major high or low fluctuations
- to prevent tissue damage
Normal blood sugar levels in people who don’t have diabetes or prediabetes range between 60 and 100 milligrams per deciliter (mg/dL) before meals, and less than 140 mg/dL after meals. For people with diabetes or prediabetes, those goal numbers are slightly higher. Their blood sugar target is between 80 and 130 mg/dL before meals, and less than 180 mg/dL after eating, according to the American Diabetes Association. The American College of Endocrinology and the International Diabetes Federation recommend a target of up to 110 to 115 mg/dL before meals and 140 to 160 mg/dL after meals, respectively. However, all organizations recognize the target depends on the individual.
Common type 2 diabetes medications
There are many medications to treat type 2 diabetes. Your doctor may prescribe one or more to help treat the condition. Following are some common type 2 diabetes medications:
Biguanides, currently available only as metformin (Glucophage, Glocophage XR) for type 2 diabetes treatment, help your body use insulin more effectively and reduce glucose production in your liver. This medication may cause nausea and diarrhea.
Sulfonylureas cause your pancreas to produce more insulin. Possible side effects are weight gain and low blood sugar.
Meglitinides and D-phenylalanine derivatives also encourage your pancreas to make more insulin. They work faster and remain in your body for less time than sulfonylureas. Weight gain and low blood sugar are possible side effects.
Thiazolidinediones help your body use insulin better. Since possible side effects are serious (higher risk of heart failure and fractures, for example), thiazolidinediones aren’t often used as the first line of defense.
DDP-4 inhibitors block the breakdown of gut hormone GLP-1, which helps increase insulin release and slow down digestion. They don’t seem to promote weight gain and don’t cause low blood sugar. They may cause nausea.
GLP-1 receptor agonists are injectable medications often prescribed with other drugs. They help increase insulin production and slow down digestion to aid in reducing blood sugar levels.
Amylin analogues slow digestion, which can help lower glucose after meals. They may cause nausea.
Alpha-glucosidase inhibitors help to reduce blood sugars after meals by slowing down the breakdown of starches and sugars. They may cause gas, diarrhea, and low blood sugar.
SGLT2 inhibitors block sodium-glucose transport proteins to prevent the kidneys from reabsorbing glucose into your bloodstream. Excess sugar is expelled through your urine. Possible side effects include increased risk of urinary tract infections and low blood sugar.
Injectable insulin may be prescribed if your body can no longer produce any or an adequate amount of insulin on its own or can’t process it properly. Injectable insulin helps your body use glucose as energy. There are several types of insulin available. Your doctor can help you determine which is right for you. Side effects may include weight gain and low blood sugar.
Reasons to change your treatment plan
You may be unhappy with your diabetes medication if it causes uncomfortable side effects. For example, if a drug causes higher levels of insulin, you’re at risk of low blood sugar. If your blood sugar goes too low, you may experience hypoglycemia symptoms such as:
- dizziness or lightheadedness
- rapid pulse
- blurred vision
It’s not uncommon for people with type 2 diabetes to experience low blood sugar now and then when on these medications. Even so, if it happens regularly, it’s a sign your medication should be re-evaluated.
You may be unhappy with your diabetes medication if you feel you’re managing your blood sugar levels adequately with lifestyle changes.
On the other hand, if you’re taking your medication as directed by your doctor and your blood sugar levels aren’t controlled, it’s time to reconsider your treatment plan.
If the cost of your diabetes medication leaves your wallet thin, you might want to think about other drug options. Work with your doctor to determine which is affordable for you. You can also talk to your doctor or pharmacist about medication discount cards and offers from drug manufacturers.
Lifestyle tips for managing type 2 diabetes
Lifestyle choices can go a long way in helping you manage blood sugar levels. They may even reduce your need for diabetes medications or help them work better. Some healthy lifestyle choices are:
- Eating a healthy diet that limits sweets and refined carbohydrates and is rich in fresh produce, whole grains, lean meats, and low-glycemic foods.
- Exercising regularly to help lower blood sugar levels and prevent weight gain. Swimming and walking are both great options.
- Tracking your blood sugar regularly as advised by your doctor. Depending on your situation and the medications you currently take, you may need to do this several times daily. Regular monitoring helps you see how lifestyle choices impact your blood sugar. It also helps you determine if your medications are doing their job.
The best way to know if your diabetes medication is working is to monitor your blood sugar levels regularly. Diabetes treatment plans aren’t usually a one-stop shop. They’re unique to each individual and subject to change.
When considering your treatment plan, keep in mind you must do your part. Your medications stand a better chance of being successful if you eat right, exercise regularly, and monitor your blood sugar consistently.
If you’re concerned about any of your diabetes medications or treatment goals, don’t hesitate to talk to your doctor. Prepare a list of your medications and any side effects you’ve experienced ahead of time to bring with you to your appointment. Have an honest discussion with your doctor about your concerns and how the medications make you feel.