People with type 2 diabetes are often prescribed several drugs to help them control their blood sugar as well as conditions related to diabetes, such as high cholesterol and high blood pressure. However, startling research findings presented at the annual scientific meeting of the American Diabetes Association in San Antonio, Texas, suggest that many, if not most, of these patients do not take all the medication they are prescribed.

“We ask a lot of our diabetic patients,” stated Andrew Morris, MD of the University of Dundee in Scotland. He described a “typical diabetes patient” from his practice who was taking two drugs for her blood sugar, one for her high cholesterol, and three for lowering blood pressure. “This is a typical scenario for our patients with diabetes,” he noted.

He reported on a study that examined whether people with type 2 diabetes actually fill all of their prescriptions for diabetes medications. He and his colleagues analyzed prescription and pharmacy records for almost 3,000 people with diabetes. They found that only one-third refilled their prescriptions often enough to allow them to take at least 90 percent of their pills.

Because many patients with type 2 diabetes take more than one or two medications, the researchers also looked at whether there was any effect of the number of different drugs patients were prescribed. Morris reported that the more pills a patient was supposed to take in a day, and the more different medications they were supposed to take, the less likely they were to fill their prescriptions appropriately.

For example, two types of medications taken for diabetes are sulphonylurea drugs and metformin. About one-third of the patients who were supposed to take just one of these drug actually filled their prescriptions enough to take the medication consistently. But among patients who were supposed to be taking both drugs, only about 13 percent filled their prescriptions appropriately, Morris reported.

“The patients who were on one tablet a day, rather than two, three, or four tablets a day, tended to be better adherers,” noted Morris. In addition, the longer a patient had had diabetes, the less likely that patient was to comply fully with drug prescriptions.

“I’m a great believer in the phrase ‘diabetes fatigue’” Morris said. “It’s not as easy as we think. Type 2 diabetes is not a sprint, it’s a marathon. We ask our patients not only to adhere to their diet and their exercise, but sometimes as many as six or seven tablets a day, and it’s difficult. I think as a profession, we need to look at ways to try to simplify the regimen.”

“We don’t think this is unique to our region of Scotland,” concluded Morris. “We think this is a phenomenon not only in the U.K. and Europe, but world wide. Type 2 diabetes is a difficult condition for the patient, and the challenge is for us to understand the issues, and to try and deliver a simpler method of care.”

David Berenbeim, MD, of PacifiCare Health Systems in California agreed. He reported that when his organization did a similar survey among about 2,800 patients with type 2 diabetes in Texas a few years ago, there were similar findings — most patients were not taking their medications fully. As a result of their inconsistent use of the drugs prescribed, these people suffered more medical problems than they would have if they’d been able to keep better control over their blood sugar levels.

“What we found was that there was certainly a strong statistical relationship between the adherence rate for medication and the outcomes we looked at, at the end of the study,” such as emergency room visits, and other indications of poorly controlled diabetes, reported Berenbeim.

“The seriousness of diabetes is not appreciated,” stated Gerald Bernstein, M.D., past president of the American Diabetes Association and moderator of the session. “In the United States, diabetes is the leading cause of blindness, kidney failure, and non-traumatic amputation, and 50 to 60 percent of all heart disease comes from diabetes.”

“All of this is preventable,” he concluded. “When you lower blood sugar [by taking diabetes medications appropriately], you’re going to prevent and reduce complications.” The presenters agreed that the challenge for healthcare professionals is to help educate patients about the seriousness of diabetes and the degree to which patients can reduce their risk of serious complications by controlling their blood sugar early.

Editorial Commentary: The results of this study are similar to others in which patients are less likely to take medication if they have to take pills more frequently or take more pills each day. In general, no-one likes to take medication and patients with diabetes may need to take 6 to 10 different drugs per day. Additionally, they often don’t feel sick and the medications they take are to prevent disease rather than to treat an acute illness. On the other hand, patients who take their pills regularly have a tremendous amount to gain. Drugs to lower blood sugar levels prevent blindness, kidney failure, amputation, impotence and other diabetic complications. Drugs to lower cholesterol and blood pressure lower the risk of heart disease and stroke. Clearly these benefits cannot be realized unless medication is taken. Often it helps for people to understand what each drug does and why they should be taking it. Therefore, it is important for people to talk to their healthcare providers to devise a drug regimen that will maximize health goals as well as simplify how drugs are taken. If you have a problem taking a particular drug, this should also be discussed so an alternative can be considered.

Related posts:

1. Lantus: Long-Acting Insulin for Diabetes Brand Name: Lantus Active Ingredient: insulin glargine (rDNA origin) injection Indication: Treatment of adults and children with type 1 diabetes mellitus, and adults with type 2 diabetes mellitus who require long-acting insulin for control of hyperglycemia Company Name: Aventis Pharmaceuticals Availability: FDA approved...
2. Lowering Cholesterol Lowers Risk of Heart Attack in Diabetics Past research has shown that people with type 2 diabetes have at least twice the risk of developing coronary heart disease as those without diabetes. And once diabetics develop heart disease, their prognosis is worse than non-diabetics. Therefore, doing what it takes to...
3. Unhappiness In Your Relationship Can Trigger Diabetes If you’re unhappy with your partner, you’re twice as likely to develop diabetes as someone who is happily married or cohabitating, according to a new study presented at 60th Scientific Sessions of the American Diabetes Association in San Antonio. This study, a part...
4. Liver’s Role in Diabetes Gets Closer Look Ordinarily, the organ most associated with diabetes is the pancreas. After all, that’s where insulin is made. However, researchers from Boston suggest that the liver deserves a closer look. This team of researchers bred genetically altered mice, so the insulin receptor cells in...
5. Medications that Zap Your Cholesterol Talk to your pharmacist! Cholesterol and its Role in the Body Cholesterol is a type of fat, which we need in our diet to help us build cells in our body and make hormones, which act as chemical messengers. The body also uses...