Why Your Diabetes Medications Aren’t Working

Pills for type 2 diabetes scattered from prescription bottles, illustrating medication management challenges.

Whether you currently have Type 2 diabetes or have recently been told you’re pre-diabetic, you’ve most likely been prescribed — or told you may need to start taking — a medication for your blood sugar.

But here’s the truth most people aren’t told…

Type 2 diabetes medications don’t fix the REAL problem – because high blood sugar is only a symptom of the real problem.

In my post, What Is Type 2 Diabetes – Really?, I explained what’s really going on in Type 2 diabetes and how it’s so much more than “high blood sugar.”

The real problem is insulin resistance 

— which often develops over many years due to dietary habits, lifestyle, and environmental stressors. Several contributing factors include:

• Eating too many processed and refined carbohydrates, from flours or sugar

• Poor gut health (often caused by diet)

• Too much stress (physical, emotional, immune, or metabolic)

• Not moving your body enough

• Lack of sleep

• Toxins in food and the environment

Here’s the kicker…

None of the current medications for Type 2 diabetes actually address, repair, or fix insulin resistance. And none of them address the real issues listed above that created the problem in the first place.

You may have heard it said, “You can’t out-medicate a poor diet.” And you also can’t take a pill that makes you exercise, sleep more, reduce stress, or detoxify your body from environmental toxins.

That’s why so many people say things like:

“I’ve been on meds for years, but nothing’s really changed.” 

“They keep increasing the dose, but I still feel the same.” 

“Now I’m being told I’ll need insulin.”

Basically, what most medications do is help manage your blood sugar levels — but they don’t help your body heal or reverse what’s really going on. They make your blood sugar numbers “look” better, while the root problem stays the same (or in reality, it gets worse over time).

What most medications do is help manage your blood sugar levels...They make your blood sugar numbers “look” better...

So if medications don’t actually solve the problem of insulin resistance, what do they do?

Let’s take a look.

What do your medications actually do?

1. Insulin & Insulin Secretagogues (e.g., Insulin injections, Sulfonylureas like Glimepiride & Glipizide)

   1. Mechanism: They increase insulin levels in the body to help lower blood sugar.

   2. These drugs treat the symptom (high blood sugar) but worsen the root cause — high insulin and insulin resistance.

   3. Over time, they lead to weight gain and require increasing doses, further fueling the disease.

      
      

2. Biguanides (e.g., Metformin)

   1. Mechanism: Reduces the liver’s production of glucose, decreases glucose absorption from the intestines, and increases glucose uptake into cells.

   2. Improves insulin sensitivity slightly, only because it increases glucose movement into the cell.

   3. One of the better first-line treatments because it doesn’t increase insulin and helps reduce the liver’s glucose output. However, it still doesn’t address the lifestyle root causes.

      
      

3. Alpha-Glucosidase Inhibitors (e.g., Acarbose)

   1. Mechanism: Slows down glucose absorption in the gut to reduce blood sugar spikes after meals.

   2. Not commonly used because of side effects like bloating and gas.

   3. Helps reduce sugar absorption, but doesn't solve insulin resistance.

      
      

4. DPP-4 Inhibitors (e.g., Januvia, Tradjenta)

   1. Mechanism: Inhibits DPP-4 enzyme in the gut to prolong incretin (a gut hormone) levels, which stimulate insulin production and release from the pancreas while decreasing glucagon secretion (which decreases glucose production from the liver).

   2. These have modest effects and are often expensive with limited benefits.

   3. They still aim to tweak insulin signaling rather than reverse the root cause.

      
      

5. GLP-1 Agonists or Incretin Mimetics (e.g., Ozempic, Trulicity, Mounjaro)

   1. Mechanism: Mimics incretin hormones action in the gut. This increases insulin secretion, slows digestion processes and stomach emptying, reduces appetite, and decreases glucagon secretion (which decreases glucose production from the liver).

   2. These can be beneficial, especially for weight loss and appetite control, and can be a helpful tool while beginning to make dietary habits and lifestyle changes. 

   3. However – they only manage the condition but still don’t reverse insulin resistance.

      
      

6. SGLT2 Inhibitors (e.g., Jardiance, Farxiga)

   1. Mechanism: Increase urinary excretion of glucose from the kidneys. They force the kidneys to spill glucose into the urine, thereby reducing blood sugar levels.

   2. These work independently of insulin, so they don’t worsen insulin resistance.

   3. Help reduce sugar levels, but one of the side effects of doing so is common urinary tract infections. Can be of benefit alongside lifestyle and dietary changes, as they are more effective than medications alone.

      
      

7. Thiazolidinediones (e.g., Pioglitazone)

   1. Mechanism: Lowers blood sugar by increasing cells response to insulin without increasing insulin secretion.

   2. Not as commonly used because they can cause congestive heart failure or make it worse.

   3. Helps reduce sugar levels but doesn't solve insulin resistance.

As you can see from each description, diabetes medications for the most part either reduce blood sugar levels by pushing more sugar into the cells or help your body produce and release more insulin (which attempts to push more blood sugar into your cells).

They help manage your blood sugar numbers — but they don’t reverse insulin resistance.

That’s why the longer someone takes these medications without changing anything else, the more likely they are to need higher doses, more medications, or eventually insulin injections. The problem keeps progressing because the root cause hasn’t been addressed.

But here’s the good news:

You’re not stuck.

So, If You Don’t JUST Want to Manage Symptoms – What’s the Solution?

The real solution lies in reducing — and even reversing — insulin resistance. And that starts with improving the things that led to it in the first place, like:

• What you eat

• How well your gut works

• How much stress you’re under

• How well you sleep

• And what your body is exposed to in your environment

  
  

None of these things gets fixed overnight. But when you start addressing them — even slowly, and one at a time  — your body begins to respond.

Because it’s not broken, it just needs the right support.

In the next post, I’ll show you exactly how to begin making those changes — one step at a time — and start retaking control of your health.

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Hi, I'm Derek Dean and I help people with Type 2 Diabetes and Prediabetes balance their blood sugar & lower their A1c without relying on more medications so they can confidently reclaim their health and live with more energy, freedom, & control.