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Are Oral Medications the Right Choice?

One of my goals as a Diabetes Advocate is to ensure that people with diabetes understand that the goal of their diabetes treatment and lifestyle choices is not the elimination of all medications. The goal of any regimen we follow is to have controlled blood sugars. Controlled blood sugars may happen through diet and exercise, but may also happen with the help of medications such as oral agents, and/or insulin.

Unfortunately, many people with type 2 diabetes see the use of these medications as a mark of failure. Sort of like a scarlet letter that shows the world how we’ve ‘failed’ as a person for having ‘allowed ourselves’ to develop type 2 diabetes. In many ways, these attitudes are both the result of a culture which imposes harsh judgment of people with diabetes, through unfairly balanced media coverage, and through cultural misconceptions and lore.

However medications are there to help us, and not to hurt us. They are not the enemy in the battle against diabetes – high blood sugar is. When we’re considering the usage of medications, there are some things we should keep in mind:

Type 2 diabetes is a progressive condition:

While we may live for some time without need for medications, the fact is that with time, we may not be able to keep our numbers well controlled without extra help. This is not a failure on our part to keep a good regimen.  It just means it’s time for an extra hand.

Oral agents are not deadly:  

High blood sugar is. As with every medication, there are side effects and potential risks. But these risks are much lower than the risks you pose by having uncontrolled, high blood glucose.

Your doctor can help find the right medications for you:

Yes, some medications have some very unpleasant side effects. But with a little discipline, sticking with the medication, and taking the medication as advised, many of these side effects subside with time. Don’t stop taking a medication on your own, without first consulting your doctor. If a medication’s side effects are not improving, or are too unpleasant, please do not give up on oral agents entirely. Speak to your doctor about finding the right combination for you, or ask to be referred to an endocrinologist (a doctor who specializes in diseases of the endocrine system, such as diabetes).

Not being on medications is not always what we think:

When we’re not on medications, it is up to us to control our blood glucose levels by watching our diets, and exercising regularly. However, the pancreas is still working hard at mopping up any extra glucose that not only came from our meals, but that might have been kicked in by our livers. Some medications, such as Metformin, give the pancreas a rest because they a.) keep the liver from dumping excessive glucose (that our pancreas would have to ‘mop up’), and b.) make our tissues more responsive to the insulin we already make, so that the pancreas doesn’t have to keep producing more and more insulin, eventually leading to its exhaustion. Giving the pancreas a rest can slow down this progression.

The daily management of diabetes takes discipline and a constant awareness of our condition. But when we’ve done all we can on our end to control our high blood glucose numbers it is not a mark of failure to go on oral agents or medications. It is simply diabetes doing what diabetes does. You deserve to live with well controlled blood glucose numbers. Consult your medical team if you feel it’s time for medications, or if your medications are not working anymore.

In the next post, we will be discussing the fear and misconceptions of insulin.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.