Know your diabetes medications

WHEN you have diabetes, your medications are your best friends, as they will help you keep your condition under control.

“Diabetes control is important, not only to relieve symptoms of high blood glucose but also to reduce the complications of diabetes,” says Dr Hew Fen Lee, consultant endocrinologist.
There are many complications that can occur with uncontrolled diabetes, and none of them are pleasant. You certainly don’t want to end up losing your vision, having your leg amputated, suffering kidney failure, or worst of all, dying from a heart attack.

"Lifestyle modifications with a balanced diet, regular exercise and no smoking are essential to optimise diabetic control,” Dr Hew advises.

However, he adds that in many cases, lifestyle modifications are not adequate. Thus, medications, including insulin, may be needed. These help to keep blood glucose at a level that minimises complications,” he explains.

Is it insulin?

Diabetes treatment is generally divided into insulin injections, oral medications, and/or diet modifications.

Insulin is a hormone produced by your pancreas, and it helps the body use or store the glucose from food. In people with diabetes, the pancreas either no longer makes insulin or the body doesn’t respond well to the insulin.

People with type 1 diabetes must take insulin, while only some people with type 2 diabetes require it. Injecting yourself with insulin every day is something that you will get used to. There are devices like cartridges, pens and pumps, which make it easier to inject the insulin. In the future, we may even have insulin that can be inhaled!

There are many different types of insulin, such as rapid-acting, fast-acting, intermediate-acting, long-acting and pre-mixed. Your doctor will prescribe the right one for you based on your lifestyle, preferences and control of blood glucose.

If you are a type 1, you should never stop taking your insulin because it can be dangerous and life-threatening.

Insulin has very few side-effects, besides low blood glucose or hypoglycaemia. To avoid “hypo” situations, get to know your body and how activity, exercise, stress or different foods affect your blood glucose levels.

“Take regular meals and (adjust) the insulin to certain situations, for example when fasting during Ramadan, or during illnesses,” Dr Hew suggests.

“It important to monitor your blood glucose regularly to optimise blood glucose control and minimise hypoglycaemia,” he adds.

Oral medications?

Some people with Type 2 diabetes need to take pills. There are five different kinds of oral medications: sulfonylureas, meglitinides, thiazolidinediones and alpha-glucosidase inhibitors.
Overwhelmed by all these long names? Don’t be – your doctor will help you decide which type of medication is best for you.

Each type of medication works in different ways, by stimulating your pancreas to release more insulin, decreasing the amount of glucose produced by your liver, making your tissues more sensitive to insulin or blocking the breakdown of starches in the intestines. Although you may have some side effects like loose stool, water retention, or hunger and hypoglycaemia (depending on the type of medication), “many of these side effects are mild and can be relieved by taking the medications as per instructions,” Dr Hew assures. “It is important to keep to the follow-up appointments, so that the doctor can monitor your side effects.”

Time your meals regularly to your medications, so that you won’t have “hypo” episodes. At some point later, your doctor may add on another medication to what you have been taking. Don’t despair – this is not a sign that you or your doctor has failed.

“That means the existing medication is not working adequately. Thus, another type of medication may have to be added in order to further improve diabetes control,” Dr Hew reasons.

The good news is, your doctor may be able to reduce your medication if your diabetes control improves over time.

“Regular exercise and dietary modifications can help to optimise blood glucose control,” says Dr Hew. However, if you do not exercise and gain weight instead, your doctor will just have to keep increasing your medications.

No matter how effective diabetes medications and insulin are, it is still up to you to control your diabetes successfully. So be a healthier person – your doctor will applaud you for it the next time he sees you!

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Excerpt from The Star

This article is courtesy of Nestle Nutrition. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.