Should I try a new medication?Friday, 29 May 2020
There are many challenges for people diagnosed with type 2 diabetes and trying to manage the number of medications that are prescribed can feel like a burden.
One of the best ways of easing this burden is by staying in regular contact with your health care team who can advise when to change your medication.
What medication to prescribe?
There are currently eight different groups of medication that can be prescribed for type 2 diabetes.
The Royal Australian College of General Practitioners (RACGP) produces a guideline that advises general practitioners (GPs) of a format for how and when to prescribe each of these eight groups of medications for people with type 2 diabetes.
This guide is based on current scientific evidence for effectiveness, safety and cost. Your GP uses this guideline as well as their own knowledge of you and your diabetes as a basis for choosing which medication to prescribe.
Why start a new medication?
Your feedback to your GP about your experience with the medication you’re taking, as well as your regular pathology results, will help guide decisions to change or when to start a new medication.
Factors which may influence the need to start a new medication include:
- Having blood glucose levels higher than the recommended ranges. This may identify that your diabetes is progressing and your current medication isn’t as effective as it used to be;
- Any adverse effects such as constant nausea, diarrhoea or vomiting which do not resolve within a reasonable timeframe from when the medication was started;
- New, more effective medication becoming available;
- Your willingness to consider other medications such as a non-insulin injectable medication;
- Reducing pill burden, so you’re not taking so many tablets.
Which medication to start?
Ultimately, the requirement to start or change to a new medication to help manage your diabetes is a conversation between you and your GP. For that reason, start a conversation with your GP about your willingness or desire to change medication and the reasons.
Pill burden is the number of tablets that a person takes on a regular basis and the cost and effort associated with organising your medication.
There are options to reduce pill burden with type 2 diabetes such as consolidating two different medications that may be available in one larger tablet. This may reduce the number of tablets you take and the cost of additional medication.
Non-insulin injectable medication
Another option is the use of non-insulin injectable medication to treat type 2 diabetes.
These types of medication, such as Byetta, can be injected twice daily, but the newer non-insulin injectables are a once weekly injection. Two such medications are Trulicity and Bydureon.
The benefit of such a medication can reduce pill burden because you don’t need to remember to take your medication daily or twice daily.
However, these non-insulin injectables usually add to an existing regime of medication to help manage type 2 diabetes and are based on your willingness to consider injectable medications.
If you’re concerned about your blood glucose levels or diabetes management, have a conversation with your GP about other medications available and if they’re suitable for you.
You can also ask for a home medication review (HMR) assessment with your pharmacist. An HMR-qualified pharmacist can visit your home and review your medications to ensure they are working effectively together.
By Alison Crow, Pharmacist, CDE