If you are a diabetes patient who has struggled to manage your condition over the years, you know the promise new medications can hold. Newer drugs with novel modes of action can mean additional options for you, especially if existing medications have proven ineffective or lost efficacy over time.
But is the latest “breakthrough” medication the best way to go for you? New medications can have very different risks, potential side effects and interactions with other drugs or food products than existing ones. Even your physician’s office may not necessarily be aware of all of these. Retail pharmacists may not have the disease-specific focus to best serve patients with chronic illnesses.
The Right Counseling
Specialist pharmacists can provide the counseling you need and help you make sense of the risks and benefits.
Moving from a therapy that has a well-understood mechanism of action to a drug that has a novel way of working means that patients need to pay close attention to any changes in your condition, your reaction to the medication and any potential side effects.
Specialist pharmacists like myself in the Express Scripts Diabetes Therapeutic Resource Center (TRC) talk to dozens of patients every day who have questions about these medications and other disease-specific questions. Patients often want to know if a new medication is right for them. Will it prove more effective long term? Are there side effects or risk factors? How is the new medication different from existing medication?
The Latest in Diabetes Treatment
The newest medications in diabetes treatment are a class of drugs known as sodium glucose cotransporter 2 inhibitors, which were developed from a substance discovered in the bark of apple trees more than 100 years ago.
SGLT2 medications have a novel mode of action from other existing diabetes treatments. Rather than inducing the pancreas beta cells to produce more insulin – as older medications do – SGLT2 medications work in the kidneys. They reduce the reabsorption of sugar through the kidneys resulting in more sugar being eliminated from the body and lowering blood sugar levels.
This can help lower sugar levels in the body and also promote moderate weight loss, a beneficial side effect for those with diabetes because data shows that more than two-thirds of patients with diabetes are also overweight or obese.
Understand the Risks
However, like any strong medication, SGLT2 inhibitors may have side effects, including:
- Increasing bad cholesterol (the important ratio of bad to good cholesterol remains the same)
- Elevated potassium levels
- Yeast infections of the genitals and urinary tract and increased urination (the most common adverse reactions are easily treatable)
Knowing when to take your medications and being aware of potential drug interactions are also important. SGLT2 medications should be taken in the morning before the first meal of the day, so that the drug is in the bloodstream when it is needed and because it is likely to increase urination. Patients who are on a blood pressure medication or a strong diuretic (water pill) should be especially careful of increased dizziness and drink a lot of water for the first month.
Adherence Is Key
Of course, no medication is effective unless it is taken as the doctor prescribed. Every skipped dose can cost a patient, both financially and in health outcomes. Not taking your medications as prescribed is the most expensive condition facing America, as it opens the door to the possibility of life-altering complications that might otherwise be avoided.
If patients have questions, they should talk to a specialist pharmacist.
The specialist pharmacists in the Diabetes TRC have the advanced clinical training and communication skills to provide counseling that guides patients in making better healthcare decisions. In addition, specialist pharmacists help prescribers tailor treatment regimens to each patient’s needs to improve adherence, safety and efficacy while reducing costs.
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