My Responses to 3 Concerns About Diabetes Medicines

As a certified diabetes care and education specialist (CDCES), I hear common concerns about diabetes medicines when working with people with type 2 diabetes. These are my typical responses to questions and worries about drug side effects and fears.

"Ugh, my provider keeps adding medicines to my care plan."

It is common to use different diabetes medicines to target other areas of the body that keep blood sugars in healthy ranges. For example, you may be on a drug to help lower insulin resistance (typically metformin) and another to help your body remove extra sugar through the urine (usually Jardiance). That's why doctors commonly add drugs versus stopping one and starting another.^1,2

If you are concerned about your prescribed medicines, ask your doctor if you are on the maximum doses of your current medicines before adding another. In my experience as a CDCES, this does not always happen.

In my experience, there are times your diabetes medicines should be stopped or the doses decreased when starting new ones. An example is when you are starting insulin or GLP-1 drugs (Ozempic, Trulicity, Bydureon, Victoza, Rybelsus).

Ask about a combination medicine

Ask your doctor or pharmacist, or call your insurance, to see if there are combination options if you are on multiple diabetes drugs. Using the example above, if you were on metformin and Jardiance, you could be switched to Synjardy, a pill that contains both medicines. It may make life a lot easier for you.

Lifestyle habits matter

Make sure that routine activity and healthy eating patterns are a part of your daily diabetes management plan as much as possible. Medicines can complement, not replace, the benefits of these 2 habits.

"I'm worried about the side effects of medicine."

This is a valid and real concern. Every medicine has benefits and risks. There are also risks of not using them. Nothing makes me sadder than seeing someone hospitalized with a life-changing stroke because they feared using diabetes drugs over the years.

The key is knowing:

• What side effects to watch for
• How common they may be
• How to reduce the risk of those side effects
• When to contact your doctor about them

For example, metformin is a commonly used type 2 diabetes medicine known for causing side effects like nausea and diarrhea. It is no wonder folks can be hesitant about using it. However, information can help. With metformin, side effects typically lessen over time.¹

Dosage makes a difference

The dosage and type of medicine will affect a drug's side effects. For example, over 50 percent of people may experience side effects on regular metformin, whereas less than 10 percent do with extended-release metformin.¹

Also, there may be activities that can lower side effect risks, such as taking the medicine with a meal. You may be able to start on a low dose and increase the dose over time. If you feel like your daily life is being interrupted by side effects, or if side effects worsen over time, call your doctor.

"Do I have to take this medicine for the rest of my life?"

This is usually the biggest concern people bring up to me, especially when adding medicines or insulin. The reality is that most people manage their diabetes with some kind of medicine. But that does not mean it doesn't change over time.³

Lifestyle health habits can make a huge difference in your need for medicine. If your blood sugars improve with regular physical activity and good nutrition, you may be able to take fewer drugs than others. I see this happen for people with high blood sugar when they are first diagnosed with type 2 diabetes.

Other health conditions may affect your need for medicines over time as well. Changes in life priorities, resources, and abilities can all affect diabetes management plans.

For example, if you are diagnosed with a physical disability and can no longer be active, you may need more medicine. If you retired sooner than expected and are now on a limited income, your ability to pay for certain drugs may change.

Type 2 diabetes is a journey

Diabetes and its treatment truly are a journey. Doctors can only give you their best estimates of how long you will need to take a certain drug.

Remember, not every drug is for everyone. If a drug does not work for your body, it is time to go back to the drawing board. Meeting with a CDCES or pharmacist in addition to your doctor can help you learn what you need to know about your medicines.