Starting a new type 2 diabetes treatment may seem tough, especially if you were on your previous treatment for a long time. To make sure you get the most out of your new treatment plan, it’s critical to communicate with your diabetes care team regularly. Read on to learn what to expect when you start a new treatment and what to ask your doctor.
Your doctor may have changed your diabetes treatment because your prior treatment no longer managed your blood sugar levels or a medication caused debilitating side effects. Your new treatment plan may include adding a drug to your current regimen, or stopping a medication and starting a new one. It may also include diet and exercise modifications, or changes in the timing or targets of your blood sugar testing.
If your current treatment has worked well, or if you’ve lost weight, your doctor may try stopping your medications altogether. No matter what your new treatment involves, there are questions to consider.
The first 30 days are often the most challenging after starting a new treatment because your body must adjust to new medications and/or lifestyle changes. Here are some questions to ask your doctor not only in the first 30 days of a treatment change, but also throughout the first year:
1. Are these side effects related to my medication?
If you’re taking new medications, you may experience new side effects. You might feel dizzy or have digestive problems or a rash. Your doctor can help you figure out if these are from your medications and advise you on how to treat them. If you’re starting on medications that can cause low blood sugar, be sure to ask your healthcare team what symptoms to watch out for, and what you need to do if you do experience low blood sugar levels.
2. Will my side effects go away?
In many cases, side effects get better over time. But if they’re still severe after the 30-day mark, ask your doctor when you can expect improvement or when you should consider other treatment options.
3. Are my blood sugar levels OK?
Assuming you’re regularly monitoring your blood sugar, you should share the results with your doctor. Ask if your blood sugar levels are where they need to be within the first month or so of treatment. If your levels aren’t optimal, ask your doctor what you can do to stabilize them.
4. How often should I check my blood sugar levels?
When starting a new treatment, your doctor may want you to check your blood sugar more often throughout the day. After 30 days, you may be able to check less often. However, if your blood sugar isn’t well controlled, you may need to continue checking your blood sugar frequently.
5. What are some signs that my blood sugar is too high or too low?
Some diabetes drugs drive blood sugar too low and cause hypoglycemia. This may cause:
- heart palpitations
Unresolved hypoglycemia may lead to serious complications such as:
- clumsiness, as if you’re intoxicated
- loss of consciousness
High blood sugar is called hyperglycemia. Many people don’t feel symptoms of high blood sugar, especially if their blood sugar levels are regularly elevated. Some symptoms of hyperglycemia are:
- frequent urination
- increased thirst and hunger
- blurred vision
- cuts and sores that won’t heal
Long-term hyperglycemia may lead to chronic complications over time, such as eye, nerve, blood vessel, or kidney damage.
6. Can you check my A1c levels to see if my numbers have improved?
Your A1c level is an important indicator of how well your blood sugar is controlled. It measures your average blood glucose levels over a two- to three-month period. In general, your A1c level should be 7 percent or less. However, your doctor may want it lower or higher, depending on your age, health status, and other factors. It’s a good idea to have your A1c level checked three months after starting treatment and then every six months once you’ve reached your target A1c goal.
7. Do I need to tweak my diet or exercise plan?
Both diet and exercise impact blood sugar levels. So you should ask your doctor every six months or so if it’s OK to continue your current exercise regimen and diet.
Ask your doctor about drug interactions when starting a new treatment. Some foods may interact with diabetes drugs. For example, according to a 2013 review, grapefruit juice may interact with the diabetes drugs repaglinide (Prandin) and saxagliptin (Onglyza).
8. Can I have my cholesterol and blood pressure levels checked?
Maintaining healthy blood lipid and blood pressure levels is an important part of any good diabetes treatment plan. According to the American Heart Association, diabetes lowers good cholesterol (HDL) and increases bad cholesterol (LDL) and triglycerides. High blood pressure is common in people with diabetes, and can increase the risk of some complications.
To keep your cholesterol levels in check, your doctor may prescribe a statin as part of your new diabetes treatment. Your doctor may also add medications to manage blood pressure. Ask to have your cholesterol levels checked at least three to six months after starting treatment to make sure they’re tracking in the right direction.
Blood pressure levels should be checked at each doctor’s visit.
9. Can you check my feet?
Diabetes is known to wreak silent havoc on feet if your blood sugar isn’t controlled. Chronically high blood sugar levels may lead to:
- nerve damage
- foot deformities
- foot ulcers that won’t heal
- blood vessel damage, leading to poor blood flow in your feet
Ask your doctor to peek at your feet at every visit, and have a comprehensive exam at the one-year mark after starting a new treatment to make sure your feet are healthy. If you have foot problems or a foot injury, consult your doctor right away.
10. Will I ever be able to stop this treatment?
In some cases, diabetes treatment may be temporary. If lifestyle changes such as a healthier diet, regular exercise, and weight loss are successful, you may be able to stop taking or reduce some medication.
11. Should I have my kidney function checked?
Uncontrolled blood sugar may lead to kidney damage. A few months into a new treatment, it’s a good idea to have your doctor order a test to check for protein in your urine. If the test is positive, it indicates your kidney function may be compromised and your new treatment may not be working well.
Your diabetes treatment plan is unique to you. It’s not static and may change many times throughout your life. Different factors will influence your treatment such as your other health conditions, your activity level, and your ability to tolerate your medication. Therefore, it’s important to ask your doctor whatever questions you have about your treatment. It’s also vital to stay in touch with your doctor as directed so they can evaluate any new symptoms or side effects as soon as possible.