To keep your blood sugar levels controlled, it's vital to take your diabetes medications as prescribed. Follow these strategies to ensure you take them on time, every time.
When Carol Gee, 67, of Stone Mountain, Georgia, was diagnosed with type 2 diabetes nine years ago, she implemented a system to take her medications and never once veered off course. A retired inventory management specialist in the military and a teacher, Gee was familiar with the efficacy of regimens, so she knew sticking to a schedule would help ensure she would always take her diabetes medications as prescribed.
In the morning after she wakes up, showers, and brushes her teeth, Gee immediately takes Metformin (glucophage), Victoza (liraglutide), and a medication for high blood pressure. Depending on her fasting blood sugar, she’ll also take fast-acting insulin and eat within 15 minutes. At night, after she brushes her teeth, she’ll repeat the same process but replaces the fast-acting insulin with a long-lasting insulin.
Add to that rising drug costs and high insurance-plan deductibles, and you might be tempted to skip a dose or not take your medications altogether. Poor medication adherence can hinder glucose control, increase the risk of hospitalizations and complications, and even lead to death, according to an article published in July 2016 in Patient Preference and Adherence.
“People often think medication non-adherence means not taking your meds, but it can also be taking them incorrectly, taking them at the wrong times, and not taking the right dose,” says Hayley Ball, a clinical pharmacist and certified diabetes educator at Northeast Medical Group, part of Yale New Haven Health, in Trumbull and New Haven, Connecticut. Considering that definition, medication non-adherence may also lead to some unexpected and serious side effects.
For example, diabetes medications like sulfonylureas, including Glipizide (glucotrol), or meglitinides, such as Prandin (repaglinide) — both of which stimulate insulin production — are best taken before you eat a meal.
Yet if you don’t eat, don’t eat on time, or don’t eat the correct amount of carbohydrates, you run the risk of low blood sugar because “here’s this pill that’s producing more insulin and now we haven’t made any adjustment with the food to match what that pill is doing,” says Diana O’Keefe, RN, CDE, and the clinical coordinator of the Diabetes and Endocrine Institute at Atlantic Health System Morristown Medical Center in Morristown, New Jersey.
After you do eat, your blood sugar could get too high, and set off a vicious cycle. “The more they eat, the higher their sugar goes, and it’s like they’re trying to catch up,” O’Keefe says.
Left untreated, diabetes can increase your risk for cavities and gingivitis, diabetic neuropathy and diabetic retinopathy, heart disease, stroke, and in men, erectile dysfunction, to name a few complications.
Set and follow a schedule. If you take your medications at the same time every day and alongside another activity like taking a shower or feeding the dog, it can become second nature like it did for Gee. “Sometimes attributing your meds to that schedule can keep you more adherent,” Ball says.
Stay consistent. If you’re on insulin, but you’re not taking it regularly and your doctor has increased your dose, you run the risk of hypoglycemia, or low blood sugar. “Taking your prescribed insulin consistently can help with more stable blood sugar readings and monitoring that can help your doctor adjust your medications in a safer way,” Ball says.
Use a pill box. Experts agree using a pill box is one of the best ways to take your medications correctly. “Not only does it help you remember to take your meds, but it can help tell you when you’re missing your medications and prevent re-dosing,” Ball says.
Take advantage of visual reminders. If you put your pills in a place that’s highly visible — like your nightstand or dining room table — you may be more likely to remember to take them. “A little bit of caring at the beginning of the week and filling those [pill] boxes and getting them in the right spot can save you a week’s worth of angst,” O’Keefe says. Of course, if you have young children, it’s a good idea to put your medication in a medication lock box or out of their sight and reach.
Use an app. Set an alarm on your phone or download an app that sends you reminder emails, text messages, or push notifications, or one that syncs with your FitBit to send reminders.
Drink water. If you’re having a hard time taking your pills because they get stuck in your throat, make sure to take them with a full glass of water. “Eight ounces of water actually helps wash everything down,” Ball says.
Ask about the option of flexibility. For some medications, it may be possible to take them less frequently throughout the day, so speak to your doctor or pharmacist about a different schedule. “If it’s possible to tailor it to where you’re only taking them one to two times a day, you’re more likely to stay consistent with it,” Ball says.
Call your insurance company if expenses are the problem. Cost shouldn’t keep you from taking your medication correctly. Ask your doctor if you can switch brands or take the generic or formulary alternative. “Sometimes the formulary option will do the exact same thing, but it will cost the patient less,” Ball says.
Get support. Think about ways that will make taking your medication easier. Maybe it’s signing up for pharmacy delivery; a company that calls with medication reminders like Pleio GoodStart; or a medication timer cap.
If you’re worried about the side effects or how to make medication part of your everyday lifestyle, contact the American Association of Diabetes Educators for a diabetes education program in your area, contact your local American Diabetes Association office, or ask your doctor for a referral to an in-person support group. “There’s a lot of group dynamic when you put everyone who is similar in a room and let them start sharing some stories,” O’Keefe says.
The key to make sure you take your medications correctly is to find what works for your lifestyle. For Carol Gee, simply sticking to the same schedule and routine every day has been the best way to stay adherent. “In doing that every day, I don’t really have to think about it. I just know, this is what I do,” she says.
In the morning after she wakes up, showers, and brushes her teeth, Gee immediately takes Metformin (glucophage), Victoza (liraglutide), and a medication for high blood pressure. Depending on her fasting blood sugar, she’ll also take fast-acting insulin and eat within 15 minutes. At night, after she brushes her teeth, she’ll repeat the same process but replaces the fast-acting insulin with a long-lasting insulin.
“I’ve always been organized, and I believe that organization is also important when you’re taking medication,” she says, explaining that practice and repetition have enabled her to follow the plan.
Thanks to this routine, Gee is the exception: Between 38 and 93 percent of people with diabetes struggle to take their medications, according to a review published in June 2015 in Diabetes Medicine.Obstacles to Taking Diabetes Meds on Time
If you’re taking medication for diabetes — whether it’s pills or injections — it can be challenging to do it exactly the way your doctor prescribed and on the same schedule every day. If you take more than one medication, you might also have trouble remembering if, when, and how much you took.Add to that rising drug costs and high insurance-plan deductibles, and you might be tempted to skip a dose or not take your medications altogether. Poor medication adherence can hinder glucose control, increase the risk of hospitalizations and complications, and even lead to death, according to an article published in July 2016 in Patient Preference and Adherence.
“People often think medication non-adherence means not taking your meds, but it can also be taking them incorrectly, taking them at the wrong times, and not taking the right dose,” says Hayley Ball, a clinical pharmacist and certified diabetes educator at Northeast Medical Group, part of Yale New Haven Health, in Trumbull and New Haven, Connecticut. Considering that definition, medication non-adherence may also lead to some unexpected and serious side effects.
For example, diabetes medications like sulfonylureas, including Glipizide (glucotrol), or meglitinides, such as Prandin (repaglinide) — both of which stimulate insulin production — are best taken before you eat a meal.
Yet if you don’t eat, don’t eat on time, or don’t eat the correct amount of carbohydrates, you run the risk of low blood sugar because “here’s this pill that’s producing more insulin and now we haven’t made any adjustment with the food to match what that pill is doing,” says Diana O’Keefe, RN, CDE, and the clinical coordinator of the Diabetes and Endocrine Institute at Atlantic Health System Morristown Medical Center in Morristown, New Jersey.
After you do eat, your blood sugar could get too high, and set off a vicious cycle. “The more they eat, the higher their sugar goes, and it’s like they’re trying to catch up,” O’Keefe says.
Left untreated, diabetes can increase your risk for cavities and gingivitis, diabetic neuropathy and diabetic retinopathy, heart disease, stroke, and in men, erectile dysfunction, to name a few complications.
Tips for Diabetes Medication Adherence
Ask questions. If you’re unsure about any aspect of your medication prescription, ask for clarification from your primary care provider or pharmacist. “When someone understands what [their medications] do, how they work, what the side effects are and what the method of action is, they’re more likely to take them,” O’Keefe says.Set and follow a schedule. If you take your medications at the same time every day and alongside another activity like taking a shower or feeding the dog, it can become second nature like it did for Gee. “Sometimes attributing your meds to that schedule can keep you more adherent,” Ball says.
Stay consistent. If you’re on insulin, but you’re not taking it regularly and your doctor has increased your dose, you run the risk of hypoglycemia, or low blood sugar. “Taking your prescribed insulin consistently can help with more stable blood sugar readings and monitoring that can help your doctor adjust your medications in a safer way,” Ball says.
Use a pill box. Experts agree using a pill box is one of the best ways to take your medications correctly. “Not only does it help you remember to take your meds, but it can help tell you when you’re missing your medications and prevent re-dosing,” Ball says.
Use an app. Set an alarm on your phone or download an app that sends you reminder emails, text messages, or push notifications, or one that syncs with your FitBit to send reminders.
Drink water. If you’re having a hard time taking your pills because they get stuck in your throat, make sure to take them with a full glass of water. “Eight ounces of water actually helps wash everything down,” Ball says.
Ask about the option of flexibility. For some medications, it may be possible to take them less frequently throughout the day, so speak to your doctor or pharmacist about a different schedule. “If it’s possible to tailor it to where you’re only taking them one to two times a day, you’re more likely to stay consistent with it,” Ball says.
Call your insurance company if expenses are the problem. Cost shouldn’t keep you from taking your medication correctly. Ask your doctor if you can switch brands or take the generic or formulary alternative. “Sometimes the formulary option will do the exact same thing, but it will cost the patient less,” Ball says.
Get support. Think about ways that will make taking your medication easier. Maybe it’s signing up for pharmacy delivery; a company that calls with medication reminders like Pleio GoodStart; or a medication timer cap.
If you’re worried about the side effects or how to make medication part of your everyday lifestyle, contact the American Association of Diabetes Educators for a diabetes education program in your area, contact your local American Diabetes Association office, or ask your doctor for a referral to an in-person support group. “There’s a lot of group dynamic when you put everyone who is similar in a room and let them start sharing some stories,” O’Keefe says.
The key to make sure you take your medications correctly is to find what works for your lifestyle. For Carol Gee, simply sticking to the same schedule and routine every day has been the best way to stay adherent. “In doing that every day, I don’t really have to think about it. I just know, this is what I do,” she says.
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