Why Your Medicines Change Over Time
Reviewed by CDE Mehandi Sharma · Updated
Most people with Type 2 diabetes start on metformin alone. Most also find, after some years, that it is no longer enough on its own. This is normal and it is worth understanding why.
The underlying condition progresses. The cells in your pancreas that make insulin slowly lose capacity. So a treatment that held your numbers in range three years ago can gradually stop doing so, even if nothing about your diet or activity has got worse.
When that happens, a second medicine is usually added rather than the first one swapped out, because they work in different ways and the effects add up. Which one gets added depends on you — your weight, your kidney function, whether you have heart disease, whether low blood sugar is a concern, and what you can afford.
This is also why review appointments matter even when you feel fine. The point of them is to catch the drift early, while it is a small adjustment rather than a large one.
The unhelpful version of this story is treating each new medicine as a personal failure. It is not. A condition that changes over time needs treatment that changes with it.