‘I Want to Stay Off Medication’

I’m curious as to why a people living with diabetes would want to stay off medication.

My goal as a diabetes educator is to assist people living with diabetes to be as healthy as possible: physically and emotionally.

I imagine that your goal, people living with diabetes, is to reduce your risk of immediate & future health problems associated with diabetes.

So frequently I read here in our forums how people living with type 2 diabetes want to “stay off medications”.

Expense? Fear? Hypoglycaemia? Failure?

Is it the expense, the fear of hypoglycaemia or the feeling of failing with ‘diet controlled diabetes’ (of which their is not any such diagnosis) that leads to this statement? Or is the statement really……

“I want to stay off medication as long as possible, I shall be happy to use medication as the need arises”?

From Diabetes Australia comes this statement:

“Initially type 2 diabetes is treated through lifestyle modification including healthy diet and regular exercise. However, as the condition progresses, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. Type 2 diabetes is a progressive condition so eventually it may be necessary to start taking insulin to control blood glucose levels. Sometimes tablets may be continued in addition to insulin. Tablets or insulin should be incorporated into your management plan as soon as they are required. This is just the progression of the condition and should not be viewed as any kind of failure on your part.”

‘Initially’ – will depend on how early a person is diagnosed. If the blood glucose level on diagnosis warrants medication, it will be prescribed early. If the blood glucose level is only just in the diagnostic range then changes to the meal planning and level of exercise MAY be all that is required in the short – medium term.

‘Often prescribed ‘ – almost always prescribed would be a more factual comment, as over time the pancreas makes less insulin due to insulin resistance, and medication is required to asset in the maintenance of blood glucose levels on target.

Putting Prevention into Practice

By taking preventative action i.e. using medications to aid keeping the blood glucose level on target, you can then reduce the risk of health problems associated with type 2 diabetes and therefore the need for even more medication.

A good question to ask your self is “What physical attribute do I need to participate in my passion”

Example: Adam has a passion for photography. The physical attribute I need are : good eyesight (poorly managed diabetes can lead to loss of vision); & the ability to move around a landscape to get the best position to take the best photograph (poorly managed diabetes can lead to loss of nerve function in the feet & heart disease). For Adam these 2 factors are motivators to take medication when required.

Options

In Australia we are fortunate to have an exceptionally good health care system. There are seven classes of medicines used to treat type 2 diabetes. Talk with your doctor or pharmacist about which type will best suit your needs.

Ask questions like:

• Will this medication increase my risk of hypoglycaemia
• How much will this medication cost
• What are the side effects and under what circumstances should I stop this medication?
• How many days / weeks will it take for this medication to reach its best effect i.e. when should i start seeing the maximum results of this medication.

Medicines available:

1. Biguanides
2. Sulphonylureas
3. Thiazolidinediones (Glitazones)
4. Alpha-glucosidase Inhibitors
5. Dipeptidyl peptidase 4 (DPP4) inhibitors
6. Incretin mimetics
7. Sodium-glucose transporter (SGLT2) inhibitors

Ask questions, get answers that you understand.

Kind Regards,

David – Diabetes Educator @ Diabetes Counselling Online