What Next When Metformin Isn't Enough For Type 2 Diabetes

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When Type 2 Diabetes Treatment Fails, What’s Next?

For most people, type 2 diabetes changes over time — even for those who follow their treatment plan exactly as directed. As the disease progresses, your diabetes care team can help you adjust your treatment plan and manage your blood sugar levels. If a change is needed, your doctor may add new diabetes medications or suggest starting an insulin regimen. This doesn’t mean you did something wrong — shifting gears is a natural part of managing a changing chronic disease like type 2 diabetes. There are a number of factors that can contribute to a decline in blood sugar control, says Margaret Powers, PhD, RD, CDE, past-president of health care and education for the American Diabetes Association and a research scientist at the International Diabetes Center at Park Nicollet Health Services in Minneapolis, Minnesota. When type 2 diabetes first develops, you may be insulin resistant, which means you make a lot of insulin but your body can’t use it effectively, Dr. Powers says. Then, over time, you make less insulin and become insulin deficient. “This is seen a lot, but it doesn’t happen overnight — it’s a gradual process,” says Powers. Other factors, including a significan Continue reading >>

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Popular Questions

  1. MarieB

    For those of you who managed well for many years on Metformin as your only diabetes medication, and then saw your a1c creeping into the 7s, what additional med did you add? Are there classes of type 2 meds you would avoid?

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  2. David_dns

    Well, that's precisely what happened to me. My choice was insulin. I figured if I was going to something more effective I might as well go with the most powerful tool available. That's a purely personal choice, of course.

  3. MarieB

    do you remember how high your a1c was at the time? The person I'm asking for is not exactly open to taking injections, and just needs a little extra help getting numbers down.

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