There are options to consider if your oral diabetes medication stops working. Talk with a healthcare professional about changing daily habits, adding a different medication, or taking insulin types to ensure you’re using the most effective diabetes treatment.
Recall of metformin extended release
In May 2020, the
Food and Drug Administration (FDA)recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call a healthcare professional. They will advise whether you should continue to take your medication or if you need a new prescription.
Oral medicines are effective at lowering blood sugar when diet and exercise aren’t enough to manage type 2 diabetes.
Yet these drugs aren’t perfect — and they don’t always work in the long term. Even if you’ve been taking your medication just as your doctor prescribed, you might not feel as well as you should.
Diabetes drugs can and often do stop working. About 5 to 10 percent of people with type 2 diabetes stop responding to their medication each year.
If your oral diabetes drug is no longer working, you’ll need to figure out what’s preventing it from controlling your blood sugar. Then you’ll have to explore other options.
When your oral diabetes medication stops working, make an appointment with a doctor. They will want to know whether your routine has changed.
Many factors can affect how well your medication is working — for instance, weight gain, changes in your diet or activity level, or a recent illness.
It’s also possible that your diabetes has progressed. The beta cells in your pancreas that produce insulin can become less efficient over time. This can leave you with less insulin and poorer blood sugar control.
Sometimes your doctor may not be able to figure out why your medication stopped working. If the drug you’ve been taking is no longer effective, you’ll need to look at other medications.
Metformin (Glucophage) is often the first drug you’ll take to control type 2 diabetes. If it stops working, the next step is to add a second oral drug.
You have a few oral diabetes medicines to choose from, and they work in different ways.
- Sulfonylureas such as glyburide (Glynase PresTab), glimepiride (Amaryl), and glipizide (Glucotrol) stimulate your pancreas to produce more insulin after you eat.
- Meglitinides like repaglinide (Prandin) trigger your pancreas to release insulin after a meal.
- Glucagon-like peptide-1 (GLP-1) receptor agonists such as exenatide (Byetta) and liratuglide (Victoza) stimulate the release of insulin, decrease glucagon release, and slow the emptying of your stomach.
- SGLT2 inhibitors empagliflozin (Jardiance), canagliflozin (Invokana), and dapaglifozin (Farxiga) lower blood sugar by making your kidneys release more glucose into your urine.
- Dipeptidyl peptidase-4 (DPP-4) inhibitors such as sitagliptin (Januvia), linagliptin (Tradjenta), and saxagliptin (Onglyza) stimulate insulin release and decrease glucagon release.
- Thiazolidinediones such as pioglitazone (Actos) help your body respond better to insulin and make less sugar.
- Alpha-glucosidase-acarbose and miglitol decrease absorption of glucose.
You might need
Taking one pill makes for easier dosing and reduces the odds that you’ll forget to take your medication.
Another option is to either add insulin to your oral diabetes drug or switch to insulin. Your doctor might recommend insulin therapy if your A1C level — which shows your blood sugar control over the last 2 to 3 months — is very far from your goal or you have symptoms of high blood sugar, such as thirst or fatigue.
Taking insulin will give your overworked pancreas a break. It can help manage your blood sugar quickly, and it should help you feel better.
Rapid-acting types start working quickly (within 10 to 15 minutes) and control blood sugars after a meal. Rapid-acting insulin usually lasts around 2 to 4 hours. Long-acting types are usually taken once a day and used to control blood sugar between meals or overnight.
Switching to a new medication won’t necessarily correct your blood sugar levels immediately. You might need to tweak the dose or try a few drugs before you gain control over your diabetes.
You’ll see your doctor about once every 3 months to go over your blood sugar and A1C levels. These visits will help your doctor determine whether your oral medication is controlling your blood sugar. If not, you’ll need to add another drug to your treatment or switch your medication.