Having your diabetes medication change can throw your daily routine into a tailspin!
In order to keep that from happening or to help you recover if it does, Halebee suggests that you educate yourself on your overall medication strategy and details of the medications and supplements you are taking. You should also be prepared and expect that your diabetes medication will change over time.
What is your medication strategy?
Your medication strategy should completely align with your type 2 diabetes (T2DM) treatment plan. You and your primary care provider should agree on that treatment plan. You should be confident on how your medication helps you achieve those goals. And your primary care provider should help you understand how your medication strategy works to support your treatment plan. Halebee has some tips on how to talk to your primary care providers. For starters, these are some goals that should factor into your treatment plan:
- Stabilize unsteady blood sugar levels?
- Lose weight?
- Reduce your medication intake?
- Stay off of insulin?
- Maintain diet flexibility?
Treatment Philosophies
One thing that can take a some time to understand is the big picture difference between treating T2DM with insulin versus oral medication. We like to think of them as philosophical differences. Taking insulin allows you much more freedom of what and when you eat. You basically calculate your insulin needs at each meal to help your body process the meal you’re about to ingest. People love the flexibility and general lack of dietary limits. Other folks don’t like the idea of giving themselves a daily injectable. Insulin can also be very costly especially without insurance. By contrast, taking oral medications requires less thought and can be much cheaper. However, oral medications don’t adjust to your diet, which means you need to adjust your diet to the medication. What do we mean by this?
Let’s say it is your birthday and you want to go out to dinner AND have a nice piece of birthday cake for dessert. If you are on insulin you would calculate the amount of insulin needed for this dinner and the special sweet dessert and proceed. However, if you are on oral medication which is timed to work to lower your morning high level blood sugar – then eating a lot of carbs at dinner will mess that up and your medication won’t do much to compensate for a PM meal with high carbs. You may wake up in the AM with a much higher than your typically elevated blood sugar level. You’ve now thrown your blood sugar out of whack and it may take several days to recover.
Deeply understanding your medication strategy
When you were first diagnosed with T2DM your primary care provider may have prescribed some oral medication for you to take (likely Metformin), but may not have gone into much detailed about what the medication does or how it works. We think this is important for you to understand because that effects how your medication interacts with your physiology and diet. Some basic questions you should ask your primary care provider about the medication you are taking include:
- What is the treatment strategy with this medication?
- What class of diabetes medication is this?
- How does the medication work?
- What time of day should I be taking this medication?
- What should I do if I accidentally miss taking this medication at the right time?
- Should I be taking this medication before eating?
- Are there any side effects that I should expect?
- How does it work with other medication and supplements that I’m taking?
Get a handle on why you may need diabetes medication changes.
It can be frustrating to have to change your medication because it can disrupt an established part of your daily routine. However there are some very good reasons for why your T2DM medication may need to change. We list a few reasons why your medication may need to change below:
- Stopped working over time
- Too many side effects
- Newer, better medication available
- Too costly
- Bad interactions with other medication
- You don’t have insurance or your insurance doesn’t cover this particular drug
Don’t look at diabetes medication changes as a failure.
Your primary care provider should take the time to answer the questions you have about your medication change. Be prepared to go through all ow the questions we listed above! Most importantly, don’t look at this medication change as a failure on your part! Over time your body will eventually adapt to your medication and they will stop working. When that happens you may need to increase your dosage or add a new medication. It is a sad fact for example, that GlipizideTM has a 25% failure rate after 5 years1.
WHO T2DM Treatment Guidelines 2.2
You can see from the diabetes treatment plan 2.2, published by the World Health Organization (WHO), that treatment plans for T2DM are expected to change over time and should be reassess every 3 months until they your blood sugar is stable at goal level. Halebee has summarized these recommendations into the graphic below.
Halebee recommends some more resources for you:
- The American Diabetes Association says it is important to get a handle on your medication
- Learn how to talk to with you primary care provider about T2DM
- Classes of oral medications by the American Diabetes Association
- The Cleveland Clinic has a guide to how oral medications work
- A recent article from Harvard Medical School on a T2DM medication right for you
Get a handle on your medication with Halebee through herbs, exercise, and mind-body techniques may allow you to reduce your diabetes medication or stop all together. Today is the day you can take charge of your health!
References:
- Harrower AD, Wong C. Comparison of secondary failure rate between three second generation sulphonylureas. Diabetes Res. 1990 Jan;13(1):19-21. PMID: 2129025.