Last Updated on April 24, 2023 by Dr Sharon Baisil MD
Fear, cost, busy schedules—many factors can get in the way of taking your diabetes drugs. Tap into our insider tips to conquer the obstacles and control your health.
Anxiety about taking diabetes medication is understandable. You might worry about side effects, the strain on your pocketbook, or the hassle it adds to daily life. If you have type 2 diabetes, you may be able to dodge the need for medications for a while, but eventually they may become necessary. If you have type 1 diabetes, you realize pretty quickly that taking insulin is essential to your survival. Medications and insulin are tools to improve your blood glucose— and they work. “Taking your medications regularly can greatly reduce your risk of developing unwanted diabetes complications,” says David Pope, Pharm.D., CDE, editor in chief at creativepharmacist.com. Sometimes remembering to take pills or injections and keeping up with refills is a challenge of its own. “The average person with diabetes is on six medicines, so it can feel like juggling,” says Jan Berger, M.D., M.J., chief executive offi cer of Health Intelligence Partners in Chicago. We’ve got tips for staying on top of your regimen and information that may ease concerns keeping you from your healthiest self.
1. Understand your medication
If you feel reluctant about taking your diabetes medication, the solution may be as simple as grasping how they work.
“If we don’t understand why we’ve been prescribed a medication, our inner 3-year-olds come out and we say no,” Berger says. So ask questions.
For example, metformin improves fasting blood glucose readings by decreasing your liver’s production of glucose at night and increasing your muscles’ uptake of glucose. Insulin injections lower blood glucose by helping to move glucose from your blood into your body’s cells, where it’s used for energy. Sulfonylureas (such as glipizide and glyburide) increase the amount of insulin the pancreas releases.
Keep new prescription handouts in a safe place (or snap a photo) to review and ask your pharmacist questions as they come up. Now, perhaps you take your diabetes meds but not regularly. “Sometimes people are resistant to taking medicine because they just don’t feel they need it,” says Patrick Devereux, Pharm.D., of Family Medical Services Pharmacy in Bessemer, Alabama. Some patients skip pills when their blood glucose is in check—though missing just 24 hours of your sulfonylurea dosage, for example, could affect your blood glucose for up to five days. Similarly, although metformin generally improves blood glucose control in one to two weeks, it may take two to three months to exert its full benefit.
“Diabetes is progressive, so it generally gets worse over time as the pancreas wears out,” Devereux says. “People typically need to add medication, and sometimes insulin, to their eating and exercise plans at some point to stay healthy.” Some people with diabetes avoid their medicine because they feel shame about being on diabetes pills or insulin. For support, reach out to other people with similar cultural and health beliefs who have diabetes. Your health care provider may be able to help you make connections, or you can seek support through diabetes education programs, places of worship, or community centers.
2. Sidestep adverse effects
Some people with diabetes fear the side effects of their medications. Here are ways to reduce some common symptoms:
Nausea from metformin. “This can be minimized if the provider has the patient start with a very small dose of metformin, then slowly increases it,” says Susan Alexander, D.N.P., ANP-BC, ADMBC, a clinical associate professor at the University of Alabama in Huntsville. Plus, studies show the stomach upset associated with it is markedly better within 30 days. Additionally, there is an extended-release version of metformin that minimizes these side effects.
Hypoglycemia. Insulin and sulfonylureas (glyburide, glipizide, and glimepiride) are the main diabetes medications that can cause hypoglycemia (low blood sugar), Alexander says. Keeping a blood glucose meter and glucose tablets on hand can help ease your mind. Weight and appetite issues. “Although insulin and sulfonylureas may increase fluid retention or appetite, other drugs used to treat diabetes, such as metformin and GLP-1 receptor agonists (such as exenatide and liraglutide), are weight-neutral or even have been associated with weight loss,” Alexander says. “If you’re taking a diabetes medication that could affect your weight, eating sensibly and being physically active are especially important.”
3. Simplify your regimen
When you take several medications at different times, it can be difficult to keep them straight and work them into your routine. “Ask your pharmacist about medication packaging or calendar packs, in which one dose of all your medications for a certain time of day are together, such as in a blister pack,” Pope says. You also can use a smartphone app, such as Medisafe or Dosecast, for reminders. If you’d rather keep things low-tech, the standard pillbox is always an option. Pope and Devereux also encourage patients to ask pharmacies about synchronizing medications (sometimes called “medication sync”) so all drug refills can be picked up at one time each month.
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COST SAVING HACKS FOR MEDS
Talk turkey. “Ask what medications cost,” says Dr. Jan Berger. “Your pharmacist can check with your doctor about using less-expensive medication when possible.”
Don’t fear generics. “The FDA has approved generics. They’re just as safe and effective as brand-name drugs,” Berger says.
Shop around. Use websites and apps such as medfisher.com, goodrx.com, and werx.org to find the lowest prices for medications. Check prices at your local independent pharmacy.
Check with drug manufacturers. “Look for links on drug company websites that say ‘medication assistance’ or ‘patient assistance program,’ which provide medication for free or a reduced cost to those who qualify,” says Sandra Garcia, program coordinator for the Medical Assistance Program at Texas A&M Health Science Center in Corpus Christi. Find contact information for diabetes drug companies at diabetes.org or search for drug assistance programs through the Partnership for Prescription Assistance (888/477-2669 or pparx.org), rxassist.org, and rxoutreach.org.
Consider insulin pens. “Although generic insulin isn’t available, insulin pens hold a little more insulin than vials—1,500 units per box versus 1,000 units, respectively—but often cost the same copay,” pharmacist Patrick Devereux says. Ask your pharmacist about your options.
Research mail-order pharmacies. These may save you money by selling three months’ worth of pills at a time. Talk with your pharmacist to see if the option is right for you.
Use coupons. “Legitimate coupons are ones sponsored by the drug manufacturer,” Devereux says. Free pharmacy discount cards may land you on marketing lists, so steer clear.
Call your local health department. Ask about income-based medication-assistance programs.
But as the prevalence of Type 2 Diabetes Mellitus (T2DM) began increasing, there was a corresponding increase in the types of oral glucose-lowering medications.
Hi Androidena, it’s actually the other way around. During the last 20 years, we increased the number of screening tests all over the world and so we started detecting more diabetes individuals. Previously these tests were available only in the urban, well-developed areas and so the majority of individuals living in other areas were not detected as diabetic, resulting in a lower prevalence.
We have invested more research into developing more efficient oral glucose-lowering medications (OHA) as more cases were detected, resulting in different types of diabetic drugs.