Dr.Alok Purohit (PhD), Health Coach, Diabetes & Obesity educator
The decision to take medication for any condition is often a difficult one, and it is no different when it comes to treating diabetes. The American Diabetes Association (ADA) provides guidelines on when to consider medication for diabetes, and there are several risk factors to consider when making this decision. This essay will discuss these guidelines and risk factors, with references to current research.
ADA Guidelines on Medication for Diabetes
The ADA recommends that medication be considered for individuals with Type 2 diabetes when lifestyle modifications, such as diet and exercise, are not enough to manage their blood glucose levels. This is because high blood glucose levels can lead to a range of health complications, such as nerve damage, kidney disease, and cardiovascular disease (ADA, 2021). The ADA recommends starting medication if an individual’s A1C level (a measure of blood glucose control over a 3-month period) is above 7.5%, as this indicates poor glycemic control (ADA, 2021). The ADA also recommends considering medication for individuals with an A1C level between 6.5% and 7.5% if they have additional risk factors for complications, such as a history of heart disease, obesity, or high blood pressure (ADA, 2021).
There are several classes of medications that can be used to treat Type 2 diabetes, including metformin, sulfonylureas, DPP-4/GLP-1, SGLT-2 inhibitors and insulin (ADA, 2021). The ADA recommends starting with metformin, which has been shown to be safe and effective in reducing blood glucose levels (ADA, 2021). Other medications may be added if metformin alone is not sufficient to control blood glucose levels.
Risk Factors to Consider
When considering medication for diabetes, there are several risk factors to take into account. One of the most important risk factors is the risk of hypoglycemia, which occurs when blood glucose levels drop too low. There can be similar side effects of some diabetes medications, such as insulin and sulfonylureas (Inzucchi et al., 2015). Hypoglycemia can be dangerous and even life-threatening in some cases, so it is important to consider an individual’s risk of hypoglycemia when deciding on medication.
Another risk factor to consider is an individual’s overall health and medical history. For example, some medications may be contraindicated for individuals with certain medical conditions, such as liver or kidney disease (ADA, 2021). It is also important to consider any other medications an individual is taking, as some medications may interact with diabetes medications and increase the risk of side effects.
Conclusion
The decision to take medication for diabetes is a complex one that should be made in consultation with a healthcare provider. Unlike the belief in the past 2-3 decades, 70-80% type 2 diabetes can be reversed but that requires self control, discipline and a professional help, not just that of a physician for few minutes on three months, but daily management of condition and lifestyle changes.
The ADA provides guidelines on when to consider medication for diabetes, including starting medication when lifestyle modifications are not enough to manage blood glucose levels and considering medication for individuals with an A1C level between 6.5% and 7.5% if they have additional risk factors for complications. When making this decision, it is important to consider the risk of hypoglycemia and an individual’s overall health and medical history.
References:
American Diabetes Association. (2021). Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S1-S232.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association