Why are my sugar levels rising despite taking medication?

Question

Hello doctor,

I am 52 years old and was diagnosed with type 2 diabetes about six years ago. I take oral medication regularly, but over the past few months, my fasting sugar levels have been fluctuating between 140 and 170 mg/dL (milligrams per deciliter), even though I try to follow a controlled diet.

I also feel tired more often and sometimes experience increased thirst in the evenings. My HbA1c last month was 7.9 percent, which is slightly higher than my previous result. I walk regularly, but my work schedule is mostly sedentary.

Why do blood sugar levels sometimes increase despite taking medication?
What additional steps can help improve long-term glucose control?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have read your query and understand your concern.

It is quite common for blood sugar levels to fluctuate over time, even when you are taking medication regularly.

Type 2 diabetes is a progressive condition, meaning the body may gradually become more resistant to insulin or produce less of it as the years go by. In addition, factors such as stress, poor sleep, reduced physical activity, irregular meal timing, and even minor infections can contribute to higher glucose levels despite maintaining a generally controlled diet. This explains why you may notice fluctuations, particularly in fasting glucose.

Your fasting values between 140 and 170 mg/dL (milligrams per deciliter) and an HbA1c (glycated hemoglobin) of 7.9 percent suggest that your current regimen may need adjustment. Sometimes, oral medications become less effective over time, and treatment intensification is required.

Beyond continuing your regular walking routine, increasing overall daily movement (even short breaks from sitting), optimizing carbohydrate distribution throughout the day, and improving sleep quality can make a significant difference.

Investigations to be done include repeat HbA1c (glycated hemoglobin), fasting and postprandial glucose, renal function tests, and lipid profile. Regular follow-up with monitoring every three to six months using HbA1c (glycated hemoglobin) and clinical evaluation is recommended.

In some cases, adding another medication or even low-dose insulin may be considered. It would be very important to review your current treatment plan with your physician to individualize the next steps and achieve better long-term glucose control.

Hope I have addressed all of your queries and concerns.

Let me know if I can assist you further.

Thank you.