Switching to a New Diabetes Medication

For people with diabetes, getting blood sugar under control can take trial and error.

You're likely to have blood sugar readings that are too high or too low at some point, especially if you're sick or didn't follow your treatment plan as directed. But if blood sugar levels are often outside of your goal range, it's time to check with your health care provider to figure out what's going on.

If a healthy diet, regular physical activity and maintaining a healthy weight aren't enough to keep your blood sugar levels in target range, you may need medication. But sometimes finding the right medicine—or combination of medications—that works best to treat your diabetes takes some trial and error, too. And as your diabetes changes, your health care provider may need to switch your medication for better blood sugar control.

Why You Might Need to Switch Medications

Your health care provider may change your diabetes medication or adjust your dosage if:

• Your blood sugar is no longer in control. It's not uncommon for oral diabetes drugs to stop working after a few months or years. If you stop responding to a drug, know that it doesn't necessarily mean that your diabetes has gotten worse.
• You experience unmanageable side effects. All medications come with the chance of side effects, and diabetes drugs are no exception. When you're prescribed a new medication, ask your provider what side effects may occur. Some medications may cause weight gain or diarrhea, while other drugs can cause blood sugar levels to drop too low.
• You’re pregnant or plan to get pregnant. If you're on oral diabetes medicine and are pregnant or want to get pregnant, your health care provider will probably switch your medication. The safety of diabetes pills during pregnancy is unknown. What’s more, insulin resistance that occurs due to pregnancy may reduce the effectiveness of oral medicines. You’ll likely need to manage your diabetes with diet, exercise and insulin.

How to Tell If a Medication Isn't Working

Always take all medications exactly as prescribed. Diabetes medications are most effective when combined with a well-balanced diet and regular exercise. These healthy habits work with the medication to help keep your blood sugar in target range.

The best way to tell if your diabetes meds are working is to check your blood sugar. When you first start a medication, your health care provider may ask you to test your blood sugar more often than normal. Bring the record of your blood sugar results with you to each checkup. Your blood sugar levels can help your provider determine if your diabetes treatment plan—and medication—is working or not.

If you notice that your blood sugar level is all over the place, don't wait for your next visit to speak up. Contact your provider if your blood sugar is often outside of goal range. Remember that keeping your blood sugar under control can reduce your risk of getting serious health problems, like heart disease, kidney damage and blindness.

New Medication Options

Your doctor may switch your medication therapy in one of these ways:

• Change your insulin. Types of insulin vary in how quickly they work, for how long they work, and when they peak (meaning when they work the best to lower blood sugar levels). Your provider may change the type or dose of insulin you use or combine different types of insulin.
• Swap one pill for another. There are several types of oral diabetes medications available. You may respond to one drug better than another.
• Take an additional oral medication. Often, people with diabetes need to take more than one oral drug to bring their blood sugar to target levels. In fact, adding another drug to your existing medication regimen tends to be more effective than switching from one drug to another.
• Add insulin to your treatment plan. Eventually, many people with type 2 diabetes will need to take insulin along with oral medicine. Some people even stop taking oral medicine later in their illness, and rely solely on insulin when their pancreas stops producing as much insulin.
• Add another injectable medication to your drug regimen. Injectable drugs can work with other medications to keep blood sugar levels steady.

When You're Prescribed a New Medication

When your health care provider prescribes you a new medicine, it's important to understand how much, how often, when and how to take your medication. Never stop taking a drug unless directed by your provider. It's also a good idea to ask your doctor or pharmacist the following questions:

• How long will it take the medicine to work? Some drugs work quickly, while others may take days or even weeks to be fully effective.
• How will I know if the medication is working? For example, should you assume the medicine is working if your blood sugar readings are in goal range?
• When should I stop taking my current medication? And when should I start taking my new medicine?
• What side effects are common? If you experience bothersome side effects, your provider may switch your medication.
• Are there any precautions I should take? For example, should you avoid certain foods or alcohol while taking the drug?

It may take time to find the treatment plan that works best for you, and keep in mind that your treatment needs may change with time. Be sure to keep up with checkups and work closely with your health care provider to manage your diabetes well.

Reviewed February 22, 2021

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