5 Things Everyone Taking Diabetes Medications Should Do | Canton Mercy

5 Things Everyone Taking Diabetes Medications Should Do

Posted on: February 23, 2016

Diabetes can definitely be a challenging condition to manage, especially when it comes to medications. If you are diabetic, there are five key things you need to do to get the most health benefits from your prescriptions. 

Diabetic supplies - 5 things diabetics should do - Mercy Medical Center Canton Ohio

Guest post by:
Mike Shelley
Fourth Year Pharmacy Student
Northeast Ohio Medical University


As I approach the start of my career as a pharmacist at a community pharmacy, I look forward to the opportunity to help people understand and use their medications as wisely as possible. If you or someone you love is diabetic, I’d like to offer these tips, guidelines and recommendations for managing this condition.

#1 — Keep a list of your medications with you.

Keeping track of your medications can be a difficult task. Making a list is a great way to help you remember which medications you are taking and how you take them. Here are some things you should include for each medication on your list:

  • Medication name (brand and/or generic)
  • Medication strength
  • Directions
  • Prescriber

For example, you might write down: Metformin (Glucophage) 500 mg, 1 tablet twice a day, Dr. Smith; or Lantus insulin, inject 30 units daily at bedtime, Dr. Wheeler.

You may also want to add your emergency contact information, as well as the pharmacies you go to in case of an emergency. Also, make sure you update your list as changes are made to your medications!

#2 — Be familiar with the medications you take.

There are many medication options available to help lower your blood sugar; your doctor decides which medications are best for you based on your lifestyle, physical condition, how you respond to medications, and insurance coverage. Below are examples of each class of oral anti-diabetes medications and generic and brand names of each.

Medication Class       

Medications                          

Sulfonylureas

Chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, Glynase, Diabeta), glimepiride (Amaryl)

Biguanides

Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet)

Meglitinides

Repaglinide (Prandin), nateglinide (Starlix)

Thiazolidinediones

Rosiglitazone (Avandia), pioglitazone (Actos)

DPP-4 inhibitors

Sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina)

SGLT2 inhibitors

Canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance)

Alpha-glucosidase inhibitors

Acarbose (Precose), meglitol (Glyset)

Bile acid sequestrants

Colesevelam (Welchol)

 

Because the medications work in different ways to lower blood sugar, they may be used together and sometimes are available as combination tablets.

 

Brand Name          

Generic Names      

Janumet

Sitagliptin + metformin

Actoplus-Met

Pioglitazone + metformin

Glucovance

Glyburide + metformin

Metaglip

Glipizide + metformin

Kombiglyze

Saxagliptan + metformin

Prandimet

Repaglinide + metformin

Duetact

Pioglitazone + glimepiride

 

Over time, you may require insulin injections to control your blood sugar. Below are the types of insulin and their brand names.

 

Insulin Type

Insulin Names

Rapid Acting

Insulin glulisine (Apidra), insulin lispro (Humalog), insulin aspart (Novolog)

Short Acting

Regular insulin (Humulin R, Novolin R)

Intermediate Acting

NPH (Humulin N, Novolin N)

Long Acting

Insulin detemir (Levemir), insulin glargine (Lantus, Toujeo)

 

Aside from insulin, there is a newer class of injectable medications called GLP-1 analogues. These medications are injected once daily or once weekly and help decrease appetite and promote weight loss as well as controlling blood sugar.

 

GLP-1 analogues      

Exenatide (Byetta, Bydureon)

Liraglutide (Victoza, Saxenda)

Albiglutide (Tanzeum)

Dulaglutide (Trulicity)

 

For more information about your diabetes medications or any questions you may have, talk to your doctor or pharmacist!

#3 — Know your numbers!

Blood sugar is the measure of the amount of sugar in your blood. In diabetes, your body is not able to control the level of sugar in your blood and it gets too high. When your blood sugar is too high, you can develop problems with your heart, kidneys, eyes, and more.

Blood sugar is affected by many factors. Things that can make your blood sugar rise include:

  • Too much food, like a meal or snack with more carbohydrates (sugars) than usual
  • Not being active
  • Not enough insulin or oral diabetes medication
  • Side effects from other medications
  • Illness – being sick causes your body to release hormones that raise your blood sugar
  • Stress – also causes your body to produce hormones that raise blood sugar
  • Dehydration – not enough fluids in your system

Things that can make your blood sugar fall include:

  • Not enough food, or missing a meal or snack
  • Alcohol, especially on an empty stomach
  • Too much insulin or oral diabetes medication
  • Side effects from other medications
  • More physical activity than usual

Where should your blood sugar numbers be? When you check your blood sugar, you should test when you wake up or before meals and two hours after a meal. Your doctor will give you more specific instructions as to how often and when you should test your blood sugar.

General target blood sugars:

  • When you wake up or before meals: 80 to 130
  • 2 hours after a meal: less than 180

It helps to keep a log of your blood sugars; this can be very useful to your doctor or pharmacist.

A1C is the average level your blood sugar has been over the past three months. This is usually checked at least twice a year. The lower your A1C, the less risk of complications from diabetes. For most people with diabetes, the target A1C is < 7%.

If your numbers aren’t where they should be right now, don’t get discouraged! Everyone can reach their blood sugar and A1C goals. Just make sure you take your medications as directed and be open with your doctor or pharmacist about any problems you may encounter!

#4 — Have a plan in place if your blood sugar is too low or too high.

Low blood sugar (hypoglycemia) means your blood sugar has dropped too low. You may experience:

  • Shakiness
  • Sweating, chills, clamminess
  • Hunger, nausea
  • Weakness
  • Dizziness, confusion
  • Headaches
  • Blurred vision
  • Fast heartbeat
  • Being nervous or anxious

What should you do if you think you have low blood sugar? Check it. If your reading is less than 70, have 15 grams of carbohydrates to raise your blood sugar. For example:

  • 3-4 glucose tablets
  • ½ can of regular soda (not diet)
  • 6 ounces of fruit juice
  • 3-4 hard candies

Wait 15 minutes and check your blood sugar again. Repeat until your blood sugar is at least 70. If your next meal is not within the next few hours, have a light protein/fat based snack, such as:

  • 3-4 peanut butter crackers
  • Cup of milk
  • Handful of nuts
  • ½ sandwich with lean meat/cheese

High blood sugar (hyperglycemia) for most people with diabetes doesn’t cause any symptoms short-term, but over time, it can cause problems with your heart, kidneys, and vision. It can also make it easier to get infections.

If your blood sugar becomes very high, however, you may notice some of the following effects:

  • Feeling drowsy, sleepy
  • Confusion
  • Extreme thirst
  • Frequent urination
  • Flushed skin
  • Fruity breath odor (may be mistaken for alcohol)
  • Heavy breathing
  • Nausea, vomiting
  • Being unconscious

If you experience any of these symptoms, you should contact your doctor or seek medical attention right away.

#5 — Take care of your feet!

It is not uncommon for people with diabetes to lose some feeling in their feet, and having diabetes can make it easier for someone to get foot infections. Therefore, it’s important to inspect your feet every day to make sure there aren’t any problems that could lead to infection.

  • Look for cuts, bruises, or swelling and see your healthcare provider right away if there are any changes or if you hurt your feet.
  • Wash your feet every day. Use warm water and mild soap; avoid soaking since it can dry out the skin and lead to cracks. Dry them carefully, especially between the toes.
  • Keep your skin soft and smooth. Rub a thin coat of skin lotion (such as Gold Bond diabetic foot cream) over the tops and bottoms of your feet, but not between your toes.
  • If you can see and reach your toenails, trim them when needed. Trim (and file) your toenails straight across. Ask for help trimming your toenails if you have trouble reaching them or cannot see well enough to do it safely.
  • Wear comfortable shoes and socks that fit well and protect your feet.
  • Check the inside of your shoes each time you put them on to be sure the lining is smooth; shake them out to remove any loose objects.
  • You should see a podiatrist (foot doctor) at least once a year.

Image credit

Mike Shelley Pharmacy resident 2016 - Mercy Medical Center, Canton, OhioAbout Mike Shelley
Mike Shelley is currently a fourth-year pharmacy student at Northeast Ohio Medical University. He will receive his Doctor of Pharmacy degree in May 2016 and has accepted a position in community pharmacy with CVS Health.

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