Managing Your Diabetes Medicines
For many people with diabetes, staying healthy means having a full medicine chest and taking multiple medicines. Each medicine may be simple to use by itself. Yet combining several medicines takes extra care. Here’s how to prevent problems that can arise from medicine interactions and medicine errors.
Multiplying the risk
Having diabetes means you’re at increased risk for conditions such as high blood pressure, heart disease, kidney problems, and depression. Along with your diabetes medicine, you may take other medicines to keep these conditions under control. If you have health conditions unrelated to diabetes, such as arthritis or asthma, you may also need to use medicines to treat them. You could end up taking many types of medicine every day. The more medicines you take, the greater the risk is for a medicine mishap.
A medicine interaction happens when 2 or more medicines react with each other to cause an unexpected or adverse effect. Taking several medicines increases the odds of a harmful interaction. In addition, when you’re trying to keep track of several pills, it’s all too easy to make a mistake. You might forget a dose, confuse one pill for another, or take pills at the wrong time.
A dose of caution
By working with your healthcare provider, you can reduce the risk of such problems. These tips can help:
Be informed. Know what each of your medicines is for and how it should be used. Ask in advance about what to do if problems arise.
Tell each of your healthcare providers about the medicines you’re taking. Include nonprescription medicines as well as vitamins, supplements, and herbal products since these can all cause unexpected side effects. Prepare a list including each medicine’s name, purpose, strength, dosage, and directions for use.
Find out which medicines need to be taken by themselves because they block absorption of other medicines (such as iron and thyroid hormone). Also find out which need to be taken on an empty stomach or with food.
Metformin has been shown to decrease the absorption of vitamin B12 from the intestines. If you are taking metformin, it is recommended that you have your vitamin B12 levels checked periodically and take supplements if needed.
Review the list periodically with your healthcare provider. Ask whether you might be able to discontinue some medicines or replace them with more effective alternatives.
Let your healthcare provider know if you develop side effects. Also tell your provider if you’re having trouble following your medicine schedule—he or she may be able to help.
Talk with your healthcare provider before stopping any prescribed medicine and before starting any new prescription medicine, nonprescription medicine, or supplement. Ask whether it's safe to combine the product with your current prescription or nonprescription medicines.
Create a checklist for marking down each dose of medicine as you take it. Or, use a pillbox with compartments that organize your pills by day and time.
To help guide your diabetes management, your healthcare team will use agreed on clinical standards that include medicine use. Working closely with your healthcare team makes the effective use of these clinical practices much easier. With a little planning and the help of your healthcare provider, you’ll have a prescription for safer medicine use.
March 21, 2017
Metformin in the treatment of adults with type 2 diabetes mellitus. UpToDate, Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians. Qaseem A. Annals of Internal Medicine. 2012;156:218-31., Standards of Medical Care in Diabetes-2017. American Diabetes Association.
Hurd, Robert, MD,Sather, Rita, RN,Turley, Ray, BSN, MSN