Trying to avoid medication? Ever wonder if you will have to take medication to manage your diabetes? Curious how your physician knows when to recommend a medication? Worried that society relies too heavily on medications? These are all valid questions and concerns. Let’s explore below.
Will I have to take medication?
While there is no crystal ball to tell us if you will need medication to manage your diabetes, we hope you can keep an open mind and understand medication may be in your future.
You’ve worked so hard to manage your diabetes through lifestyle changes. We applaud your efforts! You’ve started moving (aka exercising) on a regular basis, lost a few pounds, learned how to manage stress, and increased the number of hours you sleep. Seemingly, you’ve done it all. Yet, your blood sugars still have room to improve.
At this juncture, it’s time to understand and accept that despite all your hard work, this disease may need intervention beyond your control. This does not mean you have failed. This only means your body is demanding more than you can physically offer.
How will my doctor know what to prescribe?
Luckily there are medical guidelines for starting and adjusting diabetes medications. Annually, the American Diabetes Association publishes Standards of Medical Care in Diabetes, and section 9 specifically addresses Pharmacologic Approaches to Glycemic Treatment. This is a verified, step by step approach to guide providers through a medication decision making tree.
You should feel confident your provider is not randomly throwing medication at you. Quite the opposite. They are going through a painfully calculated, step by step approach to safely administer medication and find the right medication(s) for you. Here’s what the decision making tree looks like.
Another medication! Why?
Perhaps so. To begin, we are lucky to have so many choices. Type 2 Diabetes is a complicated disease with eight different defects to address. Some medications not only lower blood sugars, but also help prevent heart disease and maintain kidney function.
And please remember, diabetes is a progressive disease. It changes over time. Like turning grey, at first we manage with little effort. After time, we like to maintain a certain “look” so we accept it will require additional attention. Diabetes is the same! At the beginning, you may only need one medication to meet your goals. Over time, as your body changes, you may need a new “formula” to meet your goals. Again, this does not mean you have failed. It means you are listening to your body and providing it with the help it’s asking for. Accepting help is a sign of strength!
Can I ever get off medication?
As mentioned before, diabetes is a progressive disease. If you are taking diabetes medication, know they are helping keep you blood sugars in a safe range. If you stop taking, your blood sugars will likely rise.
It’s also important to remember that many diabetes medications have secondary benefits such as protection from cardiovascular disease, heart failure and chronic kidney disease. Some medication, while not intended to lower blood sugars, are proven to reduce other long term complications that persons with diabetes are at high risk for developing. Be sure to ask your provider about the additional benefits before stopping a medication!
Questions to ask
Just like learning to drive, medication comes with rules that need to be followed for safety purposes. Often medication instructions are unclear or lack detail. It’s up to you to understand how your medications work and how to take them. Here’s a short list of questions to pose whenever you start or adjust medication.
- Is this medication known by another name? Often medications are switched by insurance so you want to know other names your prescribed medication might go by.
- How does this medication work? Get the details. Understand exactly what it is helping with and how it works in your body.
- Always confirm the dose. Often providers will write a prescription for an increased dose than what they tell you to take. This is so your insurance company approves more of your medication to last you longer.
- Ask what you should do if you miss a dose. Some medications can be safely taken within a specified time, and some can not.
- Confirm if your medication must be taken with or without food, or if it matters.
- Confirm the time of day your medication should be taken.
- Understand, and be aware of, side effects. All medications have potential side effects. Know the common side effects and if/when you should report to your provider.
- Ask if the medication affects your blood sugar? Most notably, steroid based medications will increase blood sugars, but there are dozens of other medications that may also affect blood sugars. Read more here.
- Ask if the medication has specific storage guidelines.
- Understand how you will know if this medication is working? What are the expected results? Know how long your provider will wait to evaluate.
Information to share
Care is a two-way street. While you rely on a provider to give great care, they are not mind readers. The more you share the better your care will be. Don’t be afraid to share the following
- Financial barriers
- Side effects of other medication you may have experienced in the past
- Dosing strategy - is the regime too complicated for your lifestyle?
- Medication beliefs and concerns
- Supplements, herbs and vitamins you take
Medication is not to be feared. It is to be understood. Now is your time!
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