Have Your Diabetes Meds Stopped Working?

You're faithfully taking each dose of your diabetes medication. Yet judging from how you feel, you're beginning to suspect they may not be as effective as they'd once been.

Could meds simply stop working? Unfortunately, yes. And once you find out why, you can get back on track. First off, consult your doctor, who will help you consider the various reasons why the medications may not be doing everything they should be to keep you healthy.

"The doctor will want to know if there have been any changes in your daily routine,"says Jeffrey Powell, MD, an endocrinologist at Mount Kisco Medical Group in Mount Kisco, New York and chief of endocrinology at Northern Westchester Hospital in Mount Kisco. "Any change in your level of physical activity, a recent illness, or even weight gain all have the potential to cause problems with the effectiveness of diabetes medication."

According to Powell, "another thing to consider is whether there has been a change in the time of day or night that you take the medication. And being on a new medication that is not related to diabetes could be counteracting the effects of your diabetes medication."

If you've ruled out all the other potential reasons for sudden high blood sugars, it may signal that there's been a natural decline in your beta cell function. "It's felt that the function of the beta cells continues to decline over time in diabetics," he explains. "The typical course in someone with Type 2 diabetes is that they will need more medication over time. Ultimately, they may need insulin to control their blood sugar."

But Tracy L. Breen, MD, clinical director of the Mount Sinai Diabetes Center at Mount Sinai Medical Center in New York City, says to proceed with caution.  "Before you go down that road, consider the fact that medication is not meant to do it all," she says. "There has to be a total lifestyle change, too, which means being vigilant about diet and exercise. Ask yourself if you're following a prudent diet, or whether you've been slipping up. Make any necessary adjustments, and see if this doesn't do the trick."

Breen recommends that if you are still not where you want to be in terms of your blood sugar and your weight, it's time to tell your doctor that you know you're not meeting your goal, and what other medication options are there for you. This may be the time to see if more medications are actually needed."

She explains that the course of diabetes often means that a Type 2 diabetic will need to be treated with insulin at some point in her life. "This is the natural course of the disease, and it doesn't mean that you have failed. You may just need more intensive medical therapy."

While a diabetic may initially feel very anxious about starting out with new oral medications or with insulin, they often are happier once they get over the initial anxiety.  And according to Breen, this is usually because they feel so much better when their blood sugar is where it should be.