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An Introduction to Drug treatment in Diabetes

• Drugs in type 2 diabetes
• I've got too many tablets!
• Why is it important to know the names of your tablets?
• ‘Managing’ your tablets
• Compliance
• Compound medications

Drugs in type 2 diabetes

Drugs in type 2 diabetes are increasingly prescribed in order to prevent complications rather than to improve symptoms. This means that a lot of the tablets are you are asked to take won’t make a difference to how you feel. For example the statins which are cholesterol lowering drugs will help reduce your risk of having a heart attack or stroke. If you are in your forties this may seem a very remote possibility – remember, you may reap the benefit in twenty years time.

I've got too many tablets!

‘Doctor, I’m rattling’ is an all too common observation we hear at the Diabetes Clinic. People with diabetes, particularly Type 2 Diabetes are often started on lots of different medications. Having a list of ten or more tablets is not uncommon ! These include tablets to lower blood sugar, blood pressure, cholesterol and drugs to reduce your risk of heart attacks and strokes.

Many people find this bewildering and have difficulty remembering whether they have taken their medication on a daily basis. Some choose to skip doses, especially since many of the drugs do not improve their well being. It is important to know your tablets. You should ideally know what the drugs are called and why you take them.

Why is it important to know the names of your tablets?

Many drugs can interact with (influence the action of) other drugs. These interactions may increase or decrease the action of certain medications and in some instance cause harm. When you receive a new prescription the prescribing doctor should ideally have a full list of your current medication.

‘Managing’ your tablets

• Know your drugs. After all you shouldn't be swallowing anything without knowing what it does! You should be able to identify your tablets by name and remember the dose if possible. Carry a list of your medications in your purse; this is often useful when attending clinics.
• Take your tablets regularly. If you have many tablets and tend to forget doses, obtain a dosset box from your pharmacist. A dosset box has separate compartments for different days of the week.
• If a tablet disagrees with you let your doctor know. It is important that your doctor is aware that you have had to discontinue medication.
• Find out about the common side effects of your medication. Many treatments for high blood pressure require an occasional blood test to check on your kidney function. Remind your doctor when these tests are due.
• Find out what targets you need to aim for. This is especially important with treatment of blood pressure and blood sugar.

Compliance

Compliance is a term used to describe how good you are at taking your medicine! The people who look after your health are all aware of the difficulties in taking lots of tablets. If you find it difficult try to discuss this with your doctor who may be able to cut down on some of the tablets.

Compound medications

Compound or combination tablets are increasingly used in people who have diabetes. This allows your doctor to combine two tablets in one. Some example of compound medications are :

Competact - Metformin + Pioglitazone (two glucose lowering drugs in one)

Inegy - Ezetimibe + Simvastatin (two cholesterol lowering drugs in one)

Cozaar-comp – Losartan + hydrochlorothiazide (two blood pressure lowering tablets in one)

 

Dr Nishan Wijenaike MD, FRCP
Consultant Diabetologist
West Suffolk Hospital Diabetes Service
October 2002
Updated November 2007