High Blood Sugar
It’s important to keep your blood sugar within a healthy range. This lowers your chances of diabetes complications. If your readings are too high on your current medication, your doctor might want to change the dose or try another.
This can happen even if your medication worked very well at first. Sometimes it just doesn’t do the trick by itself anymore.
If one drug doesn’t manage your blood sugar well enough, your doctor might add a second. If two don’t work, she could add a third.
Low Blood Sugar
Some diabetes medications can make your blood glucose go too low. Your doctor will call this hypoglycemia. It can be dangerous. You might see it with:
- Sulfonylureas like glimepiride (Amaryl), glyburide (Diabeta, Glynase), glipizide (Glucotrol, Glucotrol XL)
- Meglitinides like nateglinide (Starlix) and repaglinide (Prandin)
Your blood sugar might also go too low if you take combination treatments that have these drugs in them:
- Glimepiride/pioglitazone (Duetact)
- Metformin/repaglinide (Prandimet)
Talk to your doctor if you have low readings. You might need a lower dose or different medication.
Manage Side Effects
- DPP-4 inhibitors like alogliptin (Nesina), linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
- Alpha-glucosidase inhibitors like acarbose (Precose) and miglitol (Glyset)
- GLP-1 agonists like albiglutide (Tanzeum), dulaglutide (Trulicity), exenatide(Byetta), exenatide extended release (Bydureon), liraglutide (Saxenda, Victoza), lixisenatide (Adlyxin), and semaglutide (Ozempic)
- Metformin (Fortamet, Glucophage, Glumetza, Riomet)
You might have the same problem with treatments that combine these drugs. Talk to your doctor if your side effects are severe or don’t go away in a few weeks.
Drugs called SGLT2-inhibitors — canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance) — have a different set of side effects:
- Have to pee a lot
- Yeast infections in women
- Low blood pressure
Some side effects are more serious. If you take pioglitazone (Actos) or a combination drug with pioglitazone in it (Actoplus Met, Duetact), call your doctor if you have:
It’s rare, but metformin can cause a serious condition called lactic acidosis. It can come on suddenly. Get medical help right away if you are on the drug or a combination that contains it, and if you have any of the following symptoms:
- Loss of appetite
- Abdominal discomfort or diarrhea
- Muscle cramping
- Fast, shallow breathing
- Weakness or unusual tiredness