What Happens When Your Medicines Stop Working

Chapter 23 · Vihang Rahul Vasa

Never change, reduce, or stop any medicine on your own. If you feel your medicines are not working the way they used to, that is a reason to consult your doctor: never a reason to adjust the dose yourself. Everything in this chapter is my experience; the decision on your medicines belongs to your doctor alone.

This is one of the most dangerous situations a person with diabetes can face, and the most deceptive one. Because here is the frightening truth: if your medicines stop working, you may not feel anything at all. There is no alarm bell, no sudden pain, no obvious warning. Your plasma glucose (blood sugar) silently creeps up, day after day, week after week, and by the time you start noticing the symptoms, if you notice them at all, it may already be late.

That is exactly why I say this with absolute conviction: monitoring your plasma glucose (blood sugar) is not optional, it is survival. Check it preferably every day, or at the very least a couple of times a week. And get your HbA1c (glycated haemoglobin) test done every three months without fail. The HbA1c (glycated haemoglobin) gives you the big picture: your average plasma glucose (blood sugar) over the past three months. If your daily readings look fine but your HbA1c (glycated haemoglobin) is creeping up, something is wrong, and you need to talk to your doctor immediately. Good to have all family members trained in using glucometer.

Why Do Medicines Stop Working?

There are several reasons this can happen. Some are simply part of how the condition progresses: no fault of yours. Others come from our own side: weight gained, discipline slipped, a routine that quietly changed. Either way, the answer is the same: do not blame yourself, and do not adjust the medicine yourself: see your doctor. Type 2 Diabetes is a progressive condition: over time, the pancreas naturally produces less insulin, and the body’s resistance to insulin may increase. A medicine that worked perfectly for two or three years may gradually become insufficient. Your lifestyle may have changed: more stress, less exercise, different eating habits. You may have gained weight. You may have developed a new condition that affects how your body processes the medicine. Or, as we discussed in the earlier chapter, the medicine itself may be spurious. Whatever the reason, treatment needs to evolve with time, and the only way to catch the change is through regular monitoring and visiting your doctor regularly.

The Warning Signs: If They Appear at All

If your medicines have significantly stopped working and your plasma glucose (blood sugar) has risen considerably, you may start to experience the original symptoms of diabetes returning, the same warning signs (see Chapter 4), increased thirst, frequent urination, increased hunger, persistent fatigue, blurred vision, and slow wound healing. If any of these reappear, act immediately.

The Dangerous Truth

But here is what I really want you to understand, and this comes from personal experience: most of the time, you will feel absolutely nothing. Your plasma glucose (blood sugar) could be running significantly above your target range, levels your doctor would consider seriously elevated, and you might feel perfectly fine. You will go about your day, eat your meals, go to work, sleep at night, and have no idea that your medicine stopped doing its job weeks ago. The human body is remarkably good at adapting to high plasma glucose (blood sugar) levels, which means it stops complaining even when things are going wrong inside. By the time the symptoms finally show up, the damage, to your eyes, your kidneys, your nerves, your blood vessels, may already have begun.

What You Must Do

• Check your plasma glucose (blood sugar) regularly: many people benefit from daily checks, though the right frequency for you depends on your treatment, type of diabetes, and individual profile, and is best decided with your doctor. Do not rely on how you feel.

• Get your HbA1c (glycated haemoglobin) tested periodically: commonly every three months, as advised by your doctor. It is your three-month report card and the most reliable indicator of whether your treatment is working.

• If your readings are consistently higher than your target range, do not panic, do not self-adjust your dosage, and do not ignore it. Consult your doctor and schedule an appointment.

• Before assuming the medicine has failed, consider the possibilities we discussed earlier: could the medicine be spurious? Could there be a drug interaction? Has your lifestyle changed? Has your weight changed? Share all of this with your doctor.

• Your doctor may adjust your dosage, switch your medicine, add a new one, or recommend lifestyle changes. Trust the process: diabetes treatment is not passive. It asks you to stay active, in your checks, your habits, your questions to the doctor, because it evolves with you.

Remember: your glucometer does not lie, your body does. Trust the numbers, not the feeling. A five-minute check today can prevent five years of complications tomorrow.

Illustration: Chapter 23 illustrated summary. Treatment evolves: glucose monitoring and HbA1c review can reveal changes even when a person feels well.

Chapter 23 Treatment evolves: glucose monitoring and HbA1c (Glycated Haemoglobin), review can reveal changes even when a person feels well. Several causes are possible; treatment changes are doctor-led.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.