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Diabetes Medications, and the Consequences of Forgetting

For many diabetes patients, taking their medications on schedule is a challenge. Some forget regularly, and others miss a dose here or there.

Many people with diabetes rely on oral medication or insulin, or both, to control their blood glucose levels. "People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high," advises the Centers for Disease Control and Prevention.

The vast majority of diabetics control their blood sugar with medication or insulin. Twelve percent of adults with diagnosed diabetes take both insulin and oral medications, 53 percent take oral medications only, 19 percent take insulin only and 15 percent do not take either, according to federal health statistics.

What happens if people don't adhere to their medication schedules? The potential for severe consequences is tremendous.

In a 2004 study that appeared in Diabetes Care, researchers found that people with type 2 diabetes who missed doses of their medications had a greater risk of being hospitalized. The risk of hospitalization was more than twice as high among type 2 diabetics who did not adhere to their oral diabetes medications the year before.

They found that skipping a dose from time to time can be very harmful. "It isn't just the patients who completely stop their medications who are at higher risk," Dr. David Nau, assistant professor in the University of Michigan College of Pharmacy and one of the study's authors, said in a report about the study.

Doctors can help patients assess how well they have been treating their diabetes with a hemoglobin A-1-c test, which measures how well the patient's blood sugar has been controlled during the past few months.

But diabetes medications only provide part of the picture. Because of the conditions that often accompany diabetes, many people also are on cholesterol-lowering drugs or medications to treat their high blood pressure.

Marian Marcella, a registered dietitian and certified diabetes educator, says she regularly encounters diabetics who have not been completely committed to their medication regime.

"Often doctors and educators will assume patients are taking their prescribed medications," says Marcella, who works at the Northern California Diabetes Institute at Sequoia Hospital in Redwood City, Calif. "But we often find out that people forget to take their medications, sometimes once or twice a week."

She suggests that people who have trouble remembering to take their medication establish a system of using a timer or some other type of reminder. Forgetting or skipping doses-particularly those that lead to consistent blood sugar spikes-could lead to hospitalization, she says.

In addition to the medications that many people with diabetes need to take, experts advise that they also need to take care of their health in other ways. Because of the potential for problems with diabetics' eyes and feet, they are encouraged to visit ophthalmologists and podiatrists for regular examinations and care.

Adapted by Editorial Staff, January, 2005
Last update, July 2008