Guide: Talking to Your Doctor About Medications for Type 2 Diabetes


 

Related reading:Talking to Your Doctor About Insulin for Type 2 Diabetes.”


If you’re curious about diabetes medications but not sure how they work, you’re not alone! There are so many options available today to help you reach your diabetes goals. While it’s great that there are several ways to manage your blood glucose levels, it can be a bit overwhelming, too.

With only so much time during your next doctor’s appointment to talk about your diabetes medications, it helps to be prepared with questions about treatment options that may work for you.

Let’s look at some important questions to discuss with your doctor and how different medications work to help you manage your blood sugars such as: 

  • Why you’re prescribed a certain medication at diagnosis?
  • When it’s time to change or adjust a medication?
  • What to do if medications are too costly?
  • How to watch for side effects?
  • Which medications help reduce the risks of complications? 

We’ve provided some general guidance on answers to some of these questions below, but your healthcare provider can provide much more personalized responses that are specific to YOU. We encourage you to ask as many questions as you’re comfortable with. 

Questions to Ask Your Doctor about Diabetes Medications

Why am I being prescribed metformin or a sulfonylurea (SFU) at diagnosis?

Metformin is often the first medication prescribed to people with type 2 diabetes (T2D) because it’s safe, effective and it’s very affordable thanks to generic options. It does not cause low blood sugars on its own because it reduces the amount of glucose being pushed out from the liver. It also works well when combined with other prescriptions if metformin alone isn’t enough to help you reach your goals. 

Sulfonylureas, on the other hand, can cause low blood sugars because they stimulate insulin production. But they are very affordable and can be effective for people struggling with high blood sugar levels. Your doctor may prescribe a sulfonylurea if your health insurance doesn’t provide adequate coverage for other options. 

What side effects should I look out for? What do I do if I experience them?

While every medication usually comes with a few side effects, there are some side effects that should be discussed immediately with your doctor.

  • Low blood sugars: If you’re taking a medication that can cause low blood sugars, you should tell your doctor immediately. This is a sign that your dosages likely need to be adjusted.
  • Digestive issues: There are several tips and tricks to help lessen the digestive side-effects of many diabetes medications. For example, metformin should always be taken with food. You can also get the “Extended-release” formula, and many find that the side effects settle within a few weeks.
  • High blood sugars: If the medication isn’t working, tell your doctor! Every class of medications works a little differently, so you may need to try different options before finding the most effective treatment for you.

When will I know it’s time to change medications or increase the dosage of my current medication?

First, be sure to ask your doctor how quickly you should expect to see an improvement in your blood sugars on a new medication. Some medications can take a couple of weeks to have an impact while others are nearly instant. 

Secondly, if you aren’t seeing an improvement in your blood sugars within the expected amount of time, reach out to your doctor. Don’t wait until your next appointment months down the road. If your blood sugars aren’t improving, it’s a sign that either the medication isn’t the right fit for your body’s needs or the dosage isn’t high enough. If your blood sugar is going too low, consider asking your physician to lower the dosage. 

What if I don’t like the side effects of medication and I want to stop taking it?

If the side effects of certain medications are too unpleasant for you, talk to your doctor immediately to discuss other options. Every class of medications works differently to improve your blood sugars, and it can take time to find the right fit for you and your body.

My medications are costly, what else can I do?

The most affordable diabetes medications include metformin and sulfonylureas, but they may not be a great fit for everyone. If some medications are too expensive, ask your doctor if generic versions are available and if other financial assistance options—even through the manufacturer—are available, including coupons/discounts or prescription savings programs. Be sure to check your formulary to see which tier a certain medication may fall under. 

While it isn’t a substitute for medications, you can also work on improving your sensitivity to insulin. Do keep in mind that many people with diabetes need help from medications or insulin regardless of weight loss and lifestyle changes, but making small changes can still make a big difference in achieving your goals.

Anyone—with or without diabetes—can try to improve their levels of insulin sensitivity through lifestyle changes around food, beverages, stress management and physical activity.

For example, if you’re usually drinking more than one sweetened beverage such as soda each day, reducing your intake to just one per day can have a big impact on your blood sugar. 

The same can be said for adding 20 to 30 minutes of walking to your day. Physical activity can increase your body’s uptake of glucose from your bloodstream and increase your sensitivity to insulin. 

Are some medications better at reducing the risks of complications than others? 

Yes, for example, SGLT-2 inhibitors and GLP-1 agonists have proven to reduce your risk of cardiovascular issues, including heart attack and stroke. 

SGLT2 inhibitors have also been found to benefit your kidneys, especially in those already struggling with kidney disease. This class of drugs may actually protect your kidneys and prevent kidney failure and the need for a transplant.

Some newer GLP-1 medications have shown to be helpful in losing weight, which is a common struggle for people with T2D. This means this medication could not only help you improve your blood sugar levels but help you lose weight, too, which then improves your overall sensitivity to insulin, blood pressure levels and much more.

Are there some medications I shouldn’t take because I may have another health condition/diabetes-related complication?

Yes, for example, here are a few of the medication exceptions you should discuss with your doctor. *If you are pregnant, discuss your medication regimen with your doctor immediately.

  • SGLT2 inhibitors: if you have “renal insufficiency,” are on dialysis, or have “severe” kidney disease
  • GLP-1 agonists: if you have a history of thyroid cancer or history of diabetic ketoacidosis (DKA)
  • Sulfonylureas: if you have decreased kidney or liver function, or a history of DKA
  • DPP-4 inhibitors: if you have a history of DKA

When discussing new medication options, be sure that your doctor is aware of your full health history, other medications you take and any vitamins and supplements.

Which medications are the most convenient in terms of when to take them? 

There are a variety of options within each class of medications. In some of these classes, you can choose between an oral medication versus an injectable option. Some injectable medications have once-a-week options instead of daily injections.

For example:

  • SGLT2 inhibitors: These are oral medications, taken once or multiple times per day.
  • GLP-1 agonists: Pill and injectable options, taken daily or weekly.
  • Insulin: Injectable and inhalable options, some are taken once a day, some are taken multiple times per day.

With so many options on the market, it’s so important to discuss your options with your doctor. If you don’t like your current medication regimen and feel it’s not working well for you, reach out to your doctor immediately. For more information on the different kinds of medications used to treat type 2 diabetes, here. 

 


Educational content related to Type 2 diabetes is made possible with support from Lilly Diabetes. Beyond Type 2 maintains full editorial control of all content published on our platforms.

WRITTEN BY Ginger Vieira, POSTED 11/15/21, UPDATED 05/14/22

Ginger Vieira is an author and writer living with type 1 diabetes, celiac disease, fibromyalgia and hypothyroidism. She’s authored a variety of books, including “When I Go Low” (for kids), “Pregnancy with Type 1 Diabetes,” and “Dealing with Diabetes Burnout.” Before joining Beyond Type 1 as digital content manager, Ginger wrote for Diabetes Mine, Healthline, T1D Exchange, Diabetes Strong and more! In her free time, she is jumping rope, scootering with her daughters, or walking with her handsome fella and their dog.