There are a variety of reasons why type 2 diabetics want to change or get off of their medications: 1) the high drug prices and the monthly investment that some require. 2) The FDA has put out scary warnings concerning certain drugs like Invokana and the increased risk of amputation. Maybe this has got you thinking about either changing your medication or getting off of it entirely or 3) perhaps you’ve gotten your levels under control through diet and exercise and feel like you no longer need to take all of those pills. Regardless of your reason, you should definitely talk to your doctor FIRST before taking any drastic steps to stop the meds your taking and create a plan together. Here are a few things that your doctor might suggest…
Change Up Your Medication
Each year you should evaluate the medications that you’re on and evaluate how they’re working. Your body changes and sometimes you may need to up a dose or try a medication that works in a different way. According to Diabetic Connect, “If your A1C result is not good, it may well be related to a change in your underlying diabetes, rather than to anything you did ‘wrong’; it may simply be a clue that it’s time to update your diabetes medications.”
The most important thing you can do after discussing with your doctor your new diabetes management plan is to constantly monitor your levels for about two weeks. Diabetes Forecast shares that diabetic medications don’t work right away and could take a few days to fully react in your body. “In the first few days after you start a new medication, you may start to see lower blood glucose readings. That dip happens before the drug hits its maximum blood glucose–lowering potential… This has to do with the medication reaching what’s called its ‘steady state’—when the amount of drug entering the body equals the amount leaving it. When the drug reaches this point in the bloodstream, you’ll start to see the greatest blood glucose drop, but the size of the effect depends on how each medication works in the body and how each person metabolizes drugs.”
During this process, it would be helpful to keep a journal of what you eat, your exercise routine, any minor side effects you may be experiencing (call your doctor immediately for any dangerous complications) and your blood levels. Your doctor will find this incredibly helpful as he or she tries to find the perfect drug combination for your unique situation.
Checklist for Weaning Off a Medication
NEVER stop taking a medication without being monitored by your doctor. It could be that the medication is working and that’s why your glucose levels are where they’re supposed to be. Just stopping a medication could create havoc in your body. When you DO go to the doctor, he may ask you these three questions:
- Is your A1C is less than 7 percent?
- Is your fasting morning blood glucose under 130 milligrams per deciliter (mg/dL)?
- Is your blood glucose level at random or after a meal is below 180 mg/dL?
If you answer yes to all three of these questions, your doctor may lower or stop your doses. However, there are other factors to consider – lifestyle, diet, stress, overall health – that influence this decision, so give your doctor a complete and accurate picture of your health profile.
“Some drugs can lower the blood sugar levels below the normal range, causing symptoms of hypoglycemia. These drugs, which include insulin and those in the sulfonylurea family (which are common in patients on more than one kind of diabetes pill) need to be reduced or discontinued by the clinician as required to avoid hypoglycemia, so these are typically the first drugs to be discontinued,” explains Dr. Michael Dansinger on WebMD. “It is important that patients who take these medications check their blood sugar levels regularly, particularly while making lifestyle changes. Doing so lets us know the risk of future hypoglycemia and guides the decision about when to decrease or discontinue such medications.”
Changing your medications or weaning off of them takes time, careful instruction from your doctor, and consistently monitoring your shifting glucose levels especially at the start of this process. Remember that your health management is a collaboration between you, your doctor, and often a family member or someone close to you who helps care for you. Your plan should be customized and doable for you to succeed. “Sometimes providers forget that and prescribe a regimen that is so difficult that somebody just can’t reasonably do it,” Evan Sisson, PharmD, MHA, CDE,Sisson says. “It’s up to the provider to say, ‘What’s reasonable for you?’ ”