Taking Diabetes Meds, Do You Follow Doctor Orders?
Are you among the millions of people with type 2 diabetes who do not follow their doctor's instructions on how to take their treatment meds? Medication noncompliance is not safe nor wise, so here are some things to think about when you are prescribed diabetes medications.
It is common sense that you cannot win the lottery if you do not buy a ticket, and some say the same logic applies to diabetes medications. If you don’t follow doctor’s orders and take your diabetes medications, you won’t properly manage the disease and that can lead to serious problems and complications.
Noncompliance with medication orders is not uncommon. For example, about 40 percent of people given a prescription for antibiotics (which typically requires a 7 or 10 day course of treatment) don’t finish the drugs as prescribed. About half of individuals who have hypertension do not reduce their blood pressure because they do not follow medication instructions.
In the first case, the results of noncompliance often include resurgence of the infection, the need for retreatment (and thus additional health care costs), and the development of bacterial strains that resist the drugs. Among people with hypertension who are noncompliant, there is a significant increase in the risk of deadly and nonfatal strokes.
Noncompliance of diabetes medications
Unlike treatment with antibiotics, which typically is short-term, use of medications for a chronic disease like type 2 diabetes is usually long-term. So unless you can make and maintain the necessary lifestyle changes that may allow you to remain drug-free and perhaps even reverse type 2 diabetes, your doctor will likely prescribe oral antidiabetes drugs and maybe even insulin.
The problem is, far too many people given a prescription for type 2 diabetes meds do not follow instructions, and thus they risk their health and quality of life. In a recent statement from health psychology specialist Scott Guerin, PhD, of Atlantis Healthcare, “health outcomes improve across the healthcare spectrum when patients follow their prescribed treatment.”
Yet a review appearing in Diabetes Care reported that some studies found as few as 36 percent of diabetes patients followed their doctor’s orders for oral antidiabetes drugs and insulin and that some studies revealed patients took 67 to 85 percent of their prescribed doses.
Some studies say the statistics are even worse. A new report in Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy notes that rates of nonadherence to medication among people with chronic disease such as diabetes is 50 percent or higher.
Does this sound like you? Do you take your type 2 diabetes medications according to your doctor’s orders?
If you don’t, why? Some of the common reasons patients say they do not take their diabetes medications are:
- They don’t believe the drugs are beneficial and/or they do not understand how the drugs work. These two reasons might be alleviated if doctors and other healthcare professionals, including diabetes educators, provided easy to understand explanations about the benefits of a patient’s drugs and exactly how they work. This critical educational process is likely best done in person and not by handing patients pamphlets that explain the drugs.
- They do not like the side effects. Most of the oral antidiabetes drugs are associated with gastrointestinal symptoms, such as gas, stomach upset, and diarrhea (e.g., alpha-glucosidase inhibitors, DPP-4 inhibitors, biguanides, sulfonylureas) and/or low blood sugar.
- Cost. In fact, some patients cut their dosages in half or take their medication every other day in order to reduce their costs.
- They forget (the least common reason)
Since the number of people with type 2 diabetes continues to grow and the burden on the healthcare system and families is worsening as well, it’s critical for patients to manage their disease the best ways possible. Adherence to prescribed medication dosing is one important way to achieve this.
However, if you do not want to take medication or do not understand all of your treatment options for diabetes, then it’s time to take action. You have the power to make a change in how you manage your type 2 diabetes, and the changes you make could significantly improve your quality of life and reduce your risk of developing complications.
What actions can you take?
- Do your own research. Look for reputable research in both conventional and alternative/complementary medicine on how to manage type 2 diabetes. Make a list of ideas and questions to ask your doctor
- Talk to your healthcare provider. You should discuss your concerns regarding medications and questions about nondrug options. If you are currently taking antidiabetes medications, do not stop or change your dosage or begin an alternative treatment plan on your own. Be sure to discuss all changes with your doctor.
- Consider natural options. There are scores of studies on the benefits of natural supplements for type 2 diabetes, including cinnamon, turmeric, bitter melon, and many others. If your doctor will not discuss natural options with you, find a healthcare provider who will.
- Seek support. You are not alone; there are people with type 2 diabetes everywhere. Support can come in the form of community support groups, online forums, nutritionists, certified diabetes educators, organizations (e.g., the American Diabetes Association), and friends and family. In fact, several studies have shown that support from family and friends can have a significant impact on disease management among people with diabetes. One meta-analysis of 122 studies, for example, found that compliance with disease management was 27 percent higher when patients received practical support.
- Take the EDS. That stands for Exercise, Diet, and Stress. Resolve to exercise regularly, improve your diet, and manage stress in your life. These steps, along with weight management, can have a significantly positive impact on management of type 2 diabetes, enough so you may not need medications at all.
You can take control of your type 2 diabetes with medications or without them. In either case, resolve to do it the correct way so you can enjoy a better quality of life and help ward off serious complications of the disease.
Atlantis Healthcare news release
Cramer, JA. A systematic review of adherence with medications for diabetes. Diabetes Care 2004; 27:1218-24
DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychology 2004; 23:207–18
Herttua K et al. Adherence to antihypertensive therapy prior to the first presentation of stroke in hypertensive adults: population based study. European Heart Journal 2013; 34(38): 2933-39
Missouri Pharmacy Association
Muller TA, DiMatteo MR. Importance of family/social support and impact on adherence to diabetic therapy. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2013; 6:421-26
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