Stopping Diabetes Medicines
“I want to get off some of these drugs,” Ellen told me. “But my doctor says I need them. I’m on three for glucose, two for blood pressure, and one for depression. They’re costing me hundreds every month. What can I do?” Ellen is a health-coaching client of mine, age 62 with Type 2 diabetes. She works as an executive secretary in an insurance company. It’s stressful. She’s usually there from 8 AM until 6 PM or later and comes home “too tired to exercise.” She mentioned that just “putting herself together” for work every day requires an hour of prep time. “You have to look good for these executives,” she says. I asked about her drugs. She said she takes metformin (Glucophage and others), sitagliptin ( brand name Januvia), and pioglitazone (Actos) for diabetes, lisinopril (Privinil, Zestril) for blood pressure, simvastatin (Zocor) for cholesterol, and paroxetine (Paxil) for depression. Her A1C is now at 7.3%, down from a high of 9.9% a year ago, when she was on only two medicines. “I think the drugs are depressing me,” she said. “The cost, the side effects… I have nausea most days, I have cough from the lisinopril. That doesn’t help at work. I don’t know what’s worse, the drugs or diabetes.” What would you have said to Ellen? Although I strongly believe in reducing drug use, I told her what most experts say, that she can get off some, possibly all diabetes drugs, but it will take a lot of work. Asqual Getaneh, MD, a diabetes expert who writes for Everyday Health, says that doctors want to be “assured that an A1C will stay down” if a person goes off medicines. She says doctors usually won’t reduce medicines until A1C drops below 7.0%. In the ADA publication Diabetes Forecast, pharmacist Craig Williams, PharmD, writes, “Unf Continue reading >>
I Lost My Insurance, Stopped My Medication, And Had A Heart Attack
Tadeusz (Tod) Majka was diagnosed with type 2 diabetes when he was 31. His father had type 2 diabetes and died of a stroke, so Majka watched what he ate and monitored his blood sugar. But then he lost his job and health insurance. He slipped back into poor eating habits, and he stopped taking his medication because it was too expensive. At 38, the tool-and-die maker from Endicott, N.Y., was rushed to the hospital with diabetes-related heart disease, requiring open-heart surgery. Just as he was getting back on his feet, Majka was diagnosed with the sight-robbing condition diabetic retinopathy. Tod is slowly recovering after a serious health scare: 5 clogged arteries and open-heart surgery.(TADEUSZ MAJKA)My father had type 2 diabetes. When I was 27 years old, he underwent surgery for blocked carotid arteries in his neck. He had a stroke a few days after the surgery and was in a vegetative state for a year and a half until he died. After that I began to think that maybe I wasn't invincible; I made it a priority to get a physical every year. However, I wasn't really that worried. Even though I was 300 pounds and 5'11", I didn't consider my weight a problem because I was a competitive wrestler in high school. In my opinion I took good care of myself. However, I knew I probably ate too much. Instead of one helping, I'd have at least two, sometimes more, and there were plenty of midnight snacks. My eating habits started when I was young. My mother was Italian, so most meals were enormous plates of pasta. If I didn't clean my plate, my father would yell at me. My life went to hell Then about eight years ago, I was diagnosed with type 2 diabetes too. I had put on about 40 pounds since getting married, but I was still shocked. At first it wasn't too hard to watch what I ate and m Continue reading >>
Common Questions About Diabetes Medicines
How do I know if my diabetes pill is working? The best way to find out how well your diabetes pill is working is to test your blood sugar. Ask a member of your health care team what time of day is best for testing. You'll want to test when your diabetes medicine is expected to be most active in your body. Keep a record of your blood sugar levels (PDF) during that time to see if they're at or near your goal. If your levels are at or near your goal and you're not having any problems with the medicine, then it's probably working well. If you're still not sure, talk to your doctor or other member of your care team. Can I stop taking my diabetes medicine after my blood sugar is under control? It's reasonable to think that after a person gets good blood sugar control, it means the end of managing diabetes. But that's not the case. People with type 1 diabetes aren't able to make their own insulin, so they will always need to take insulin shots every day. For people with type 2 diabetes who are on medicine, the answer isn't as clear. Sometimes when people are first diagnosed, they start on pills or insulin right away. If the person also works hard to control diabetes with diet and exercise, he or she can lower the need for medicine and might be able to stop taking it altogether. As long as the person is able to keep blood sugar levels normal with diet and exercise, there isn't a need for medicine. However, type 2 diabetes changes over time. The change can be fast or slow, but it does change. This means that even if a person was able to stop taking medicine for a while, he or she might need to start taking it again in the future. If a person is taking medicine to keep blood sugar normal, then it's important to keep taking it to lower the chances for heart disease and other healt Continue reading >>
What Happens When A Diabetic Stops Taking Their Insulin On Their Own?
7 Scary Things That Can Happen When You Don't Treat Your Diabetes Swallowing pills, checking your blood sugar all the time, or sticking yourself with needles full of insulin probably doesn't sound like your idea of a good time. But taking steps to keep your diabetes under control is your best shot at preventing a slew of frightening complications. If you don't take care of yourself, "diabetes complications typically start within 5 years; within 10 to 15 years, the majority of patients will progress to have multiple health issues," says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic. Fortunately, eating a nutritious diet, exercising, and taking your medication may not only stop complications from progressing, but can also reverse them, she says. Need motivation to stick to your treatment plan? Here's what can happen when you slack off. Your cholesterol and blood pressure rise. With type 1 diabetes, your body stops producing insulin, a hormone that regulates blood sugar; with type 2 diabetes, your body can't properly use the insulin you do produce. In turn, your HDL (or "good") cholesterol lowers, and your levels of harmful blood fats called triglycerides rise. Insulin resistance also contributes to hardened, narrow arteries, which in turn increases your blood pressure. As a result, about 70% of people with either type of diabetes also have hypertension—a risk factor for stroke, heart disease, and trouble with thinking and memory. (Add these 13 power foods to your diet to help lower blood pressure naturally.) Failing to control high blood pressure and high cholesterol, either with diet and exercise alone or by adding medications, accelerates the rate at which all your other complications progress, says Robert Gabbay, MD, PhD, chief medical officer at Joslin Continue reading >>
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Type 2 Diabetes - Self-care
You may not have any symptoms. If you do have symptoms, they may include: Hunger Thirst Urinating a lot, getting up more often than usual at night to urinate Blurry vision Infections Trouble having an erection Red skin rashes in parts of your body Tingling or loss of sensation in your feet You should have good control of your blood sugar. If your blood sugar is not controlled, serious problems called complications can happen to your body after many years. Learn the basic steps for managing diabetes to stay as healthy as possible. Doing so will help keep the complications of diabetes away. Steps include: Also, be sure to take any medicine or insulin as instructed. Your provider will also help you by ordering blood tests and other tests. These help make sure your blood sugar and cholesterol levels are each in a healthy range. Also, follow your provider's instructions about keeping your blood pressure in a healthy range. Your doctor will likely ask you to visit other providers to help you control your diabetes. These providers include a: Dietitian Diabetes pharmacist Diabetes educator Foods with sugar and carbohydrates can raise your blood sugar too high. Alcohol and other drinks with sugar can also raise your blood sugar. A nurse or dietitian can teach you about good food choices. Make sure you know how to have a balanced meal with protein and fiber. Eat healthy, fresh foods as much as possible. Don't eat too much food at one sitting. This helps keep your blood sugar in a good range. Managing your weight and keeping a well-balanced diet are important. Some people with type 2 diabetes can stop taking medicines after losing weight (even though they still have diabetes). Your provider can let you know a good weight range for you. Weight-loss surgery may be an option if you a Continue reading >>
Can You Stop Diabetes Meds?
When it comes to diabetes there are many success stories, especially among those who know that diet and exercise play a big part in blood sugar control. Medication is also key to getting your numbers into a healthy range. But if you’re like many people who take something daily for diabetes, you probably wonder if you can ever stop. Maybe -- if your blood sugar numbers are good and you’re committed to a healthy lifestyle. The first step is to talk to your doctor. Here’s what you can expect from that chat. Why Do You Want to Stop? First, know that it's OK to ask your doctor if you can stop taking meds once you’ve met the blood sugar goals you've both set, says Robert Gabbay, MD, PhD, chief medical officer of the Joslin Diabetes Center in Boston. And it can be done, he adds. The first step: Tell your doctor why you want to stop. Then he’ll ask you some questions. The doctor’s looking for specific answers, says endocrinologist Gregg Faiman, MD, of University Hospitals Case Medical Center in Cleveland. He wants to know: Is it too hard for you to keep up with taking your medicine? Do the side effects lower you quality of life? Is the medication too expensive? After that, you and your doctor have to agree about how you’re going to keep your blood sugar under control. You wouldn’t be on the drug if you didn’t need it, Faiman says. “Stopping a medication requires an in-depth discussion. You have to commit to keeping your diabetes under control.” Medication Matters If you take the drug metformin, a common treatment for type 2 diabetes, your doctor could lower it in stages as you lose weight and get fitter, Faiman says. You may even be able to stop it -- at least for a while -- if you’re making good lifestyle choices and you keep your blood sugar under cont Continue reading >>
Metformin - Oral, Glucophage
are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu Continue reading >>
Type 2 Diabetes Faqs
Common questions about type 2 diabetes: How do you treat type 2 diabetes? When you have type 2 diabetes, you first need to eat a healthy diet, stay physically active and lose any extra weight. If these lifestyle changes cannot control your blood sugar, you also may need to take pills and other injected medication, including insulin. Eating a healthy diet, being physically active, and losing any extra weight is the first line of therapy. “Diet and exercise“ is the foundation of all diabetes management because it makes your body’s cells respond better to insulin (in other words, it decreases insulin resistance) and lowers blood sugar levels. If you cannot normalize or control the blood sugars with diet, weight loss and exercise, the next treatment phase is taking medicine either orally or by injection. Diabetes pills work in different ways – some lower insulin resistance, others slow the digestion of food or increase insulin levels in the blood stream. The non-insulin injected medications for type 2 diabetes have a complicated action but basically lower blood glucose after eating. Insulin therapy simply increases insulin in the circulation. Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy. Many people with type 2 diabetes have elevated blood fats (high triglycerides and cholesterol) and blood pressure, so you may be given medications for these problem Continue reading >>
Can I Stop My Diabetes Medications?
I was recently diagnosed with type 2 diabetes. I am taking 10 mg of glipizide and 500 mg of metformin twice a day. My A1C was 12.5, but I have been feeling better, and I even stopped taking the glipizide every morning. My blood glucose average is now 170. Is that good, or should I continue to take my glipizide every morning? Continue reading >>
Taking Care Of Diabetes
Since our pancreas does not make insulin, we have to take insulin as medicine so that glucose can get from our blood and into our cells to give us energy to do things. Your doctor will tell you how much insulin you need. It can be a little scary at first and there is a lot to understand, that’s why I am here, to help you know what you need to learn. Testing Blood Glucose Because diabetes affects the glucose in your blood, it is important to measure this with a blood glucose meter. You will get used to having your blood glucose meter with you all of the time because checking your glucose level is the only way to know if your diabetes is under control. You always need some glucose in your blood, but not too much. If your blood glucose gets too high or too low it can make you feel sick so you will always want to avoid that. Your doctor will tell you what your glucose levels should be. Low Blood Glucose Low blood glucose happens when you take more insulin than your body needs. It means that too much glucose moved from your blood into your cells, not leaving enough glucose back in the blood (called hypoglycemia). This can be very dangerous. If your blood glucose is low you may feel shaky, start sweating, get a headache, feel dizzy, or your heart may start pounding. These are called symptoms, and they warn you that you need to eat or drink some sugar right away. High Blood Glucose High blood glucose happens when you don’t take enough insulin – when there is too much glucose in your blood (called hyperglycemia). High blood glucose levels can be harder to notice at first, another reason why it is important to test your blood glucose often. Most of the time, you can take insulin so that your high glucose goes down. But if you don’t take insulin and your blood glucose sta Continue reading >>
Stopping Metformin: When Is It Ok?
The most common medication worldwide for treating diabetes is metformin (Glumetza, Riomet, Glucophage, Fortamet). It can help control high blood sugar in people with type 2 diabetes. It’s available in tablet form or a clear liquid you take by mouth before meals. Metformin doesn’t treat the underlying cause of diabetes. It treats the symptoms of diabetes by lowering blood sugar. It also increases the use of glucose in peripheral muscles and the liver. Metformin also helps with other things in addition to improving blood sugar. These include: lowering lipids, resulting in a decrease in blood triglyceride levels decreasing “bad” cholesterol, or low-density lipoprotein (LDL) increasing “good” cholesterol, or high-density lipoprotein (HDL) If you’re taking metformin for the treatment of type 2 diabetes, it may be possible to stop. Instead, you may be able to manage your condition by making certain lifestyle changes, like losing weight and getting more exercise. Read on to learn more about metformin and whether or not it’s possible to stop taking it. However, before you stop taking metformin consult your doctor to ensure this is the right step to take in managing your diabetes. Before you start taking metformin, your doctor will want to discuss your medical history. You won’t be able to take this medication if you have a history of any of the following: alcohol abuse liver disease kidney issues certain heart problems If you are currently taking metformin, you may have encountered some side effects. If you’ve just started treatment with this drug, it’s important to know some of the side effects you may encounter. Most common side effects The most common side effects are digestive issues and may include: diarrhea vomiting nausea heartburn abdominal cramps Continue reading >>
What Happens If You Don't Treat Your Diabetes?
How to prevent high blood glucose level complications Diabetes can increase your risk of many serious health problems most of which are entirely preventable if you keep your blood glucose in a healthy range. Eyes - Reduce your risk of developing diabetic retinopathy, glaucoma, cataracts and other eye problems with regular check-ups. Feet - Foot problems can occur when there is nerve damage (also called neuropathy), which results in loss of feeling in your feet. Check your feet for injury and inside your shoes for foreign objects that you might not be able to see at first glance, before you put them on. Contact your healthcare professional if you do have a foot injury. Visit your healthcare professional at least once a year to have a complete foot examination. Stroke or heart attack - having diabetes increases your risk of a stroke or heart attack. You can help to reduce this risk by having regular checks of your blood pressure, cholesterol level and taking all your prescribed medication regularly. Lower your risks You can lower your risk by taking care of your health, by keeping your blood glucose, blood pressure and cholesterol on target with a healthy eating plan, regular physical activity and taking any prescribed medicine or treatment. Diabetes can cause difficulties during pregnancy such as miscarriage or a baby born with problems such as macrosomia/birth trauma, neonatal hypo, hyperbilirubinemia. Women with diabetes are also more likely to have a heart attack, and at a younger age. Some men with diabetes could experience impotence, also called erectile dysfunction this is when the man can no longer have or keep an erection. There are treatments which may help with this. Your healthcare professional is always on hand to help you, with any concerns and symptoms that Continue reading >>
7 Scary Things That Can Happen When You Don't Treat Your Diabetes
Swallowing pills, checking your blood sugar all the time, or sticking yourself with needles full of insulin probably doesn't sound like your idea of a good time. But taking steps to keep your diabetes under control is your best shot at preventing a slew of frightening complications. If you don't take care of yourself, "diabetes complications typically start within 5 years; within 10 to 15 years, the majority of patients will progress to have multiple health issues," says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic. Fortunately, eating a nutritious diet, exercising, and taking your medication may not only stop complications from progressing, but can also reverse them, she says. Need motivation to stick to your treatment plan? Here's what can happen when you slack off. With type 1 diabetes, your body stops producing insulin, a hormone that regulates blood sugar; with type 2 diabetes, your body can't properly use the insulin you do produce. In turn, your HDL (or "good") cholesterol lowers, and your levels of harmful blood fats called triglycerides rise. Insulin resistance also contributes to hardened, narrow arteries, which in turn increases your blood pressure. As a result, about 70% of people with either type of diabetes also have hypertension—a risk factor for stroke, heart disease, and trouble with thinking and memory. (Add these 13 power foods to your diet to help lower blood pressure naturally.) Failing to control high blood pressure and high cholesterol, either with diet and exercise alone or by adding medications, accelerates the rate at which all your other complications progress, says Robert Gabbay, MD, PhD, chief medical officer at Joslin Diabetes Center in Boston. More than 4 million people with diabetes have some degree of retinopathy, or dam Continue reading >>
Can I Ever Stop Taking My Diabetes Medicine?
The nutritional management of diabetes is complicated, and is discussed in detail in my textbook, Nutritional Medicine (www.doctorgaby.com). People with type 1 diabetes do not make insulin in their body, and will therefore need to continue insulin therapy indefinitely. In many cases, people with type 2 diabetes can be managed effectively with dietary modifications and nutritional supplements. Dietary modifications that may be beneficial include losing weight if overweight; avoiding refined sugar and other refined carbohydrates; and emphasizing foods that are high in fiber (particularly legumes). Nutritional supplements that may lower blood sugar levels include chromium and biotin. For diabetics with advanced kidney disease, dietary changes can be dangerous. In addition, starting a diet-and-supplement program may require a change in the dosage of diabetes medication. For these and other reasons, people with diabetes should always consult a knowledgeable healthcare practitioner before starting a nutrition program for diabetes. You should never stop taking medication prescribed without discussing it with your doctor. That being said, Diabetes comes in two forms, Type I and Type II or Insulin Dependent and Non-Insulin Dependent Diabetes. For those with Type I or Insulin Dependent Diabetes, they need to supplement the insulin that the body is no longer making, so they will be taking that medication for the rest of their lives. This is the minority type of diabetes (about 15% of diabetics) Type II or Non-Insulin Dependent Diabetes is the majority of diabetics (about 85%) and has a lot to do with insulin resistance rather than a lack of insulin production. This resistance occurs generally due to the patient being overweight and the cells of the body being constantly saturated Continue reading >>
6 Diabetes Medication Mistakes To Avoid
Treating type 2 diabetes can be tricky. Here are common mistakes that can prevent you from taking your medication as prescribed and tips for avoiding them. iStock.com If taking medication is part of your type 2 diabetes treatment plan, following your doctor's directions is essential. “It's important you take your medications on schedule because they have a timed-release,” says Toby Smithson, MS, RDN, LDN, CDE, a spokeswoman for the Academy of Nutrition and Dietetics, the co-author of Diabetes Meal Planning and Nutrition for Dummies, and founder of DiabetesEveryDay.com. Your healthcare provider has calculated the dosage and scheduling to best manage your blood sugar levels and keep them within normal range. There's no single, exact formula when it comes to treating diabetes. But following your individualized course of diabetes medication makes it more likely to work as desired, says Matthew Corcoran, MD, CDE, ASCM, an endocrinologist in Egg Harbor, New Jersey, and founder of the Diabetes Training Camp at Franklin & Marshall College near Lancaster, Pennsylvania. Controlling type 2 diabetes through medication and lifestyle changes can help you avoid serious complications such as heart disease, blindness, and kidney and nerve damage, according to the Independent Diabetes Trust. Yet it can be easy to get off track with your diabetes treatment plan, especially if you're newly diagnosed and think of yourself as healthy, according to a study published in April 2015 in Diabetes Care. Here are common mistakes that may prevent you from sticking to your prescription routine and how you can avoid making them. Mistake #1: You don't realize the role of your medications. “It is important you understand how the medications you are taking work,” Dr. Corcoran says. You’re more l Continue reading >>