Question: My doctor told me that she did not want to prescribe insulin for me, but when I got to the pharmacy, they gave me a medicine to inject. Is this insulin?
There are several injected medications for the treatment of diabetes that are not insulin. A commonly used class of medications that are mostly injected are the glucagon like peptide -1 agonists (GLP-1 agonists). These drugs help lower blood sugar, promote weight loss, and have a low risk of causing low blood sugar (hypoglycemia). Some of the drugs in this class can also protect your heart. Another benefit of the GLP-1 agonists is the injection ‘pen’ – it uses the smallest needle available, so it is not so painful. Lastly, some GLP1-agonists are conveniently dosed just once a week.
Question: I’ve seen television commercials about diabetes medications that protect the heart. Does diabetes affect the heart?
Yes, diabetes can affect many systems in the body, including the heart. When your blood sugar is high, especially for a long time, it can lead to a condition known as insulin resistance. Insulin resistance is linked with high blood pressure, high levels of bad cholesterol including triglycerides, obesity, and more. Managing diabetes is more than just keeping your blood sugar under control. It is also about managing your blood pressure, cholesterol levels and weight to prevent heart disease..
Question: My blood sugars are not always high, so can I just take my medications on days that I need help lowering the sugar levels?
It is a common thought that medications to treat type 2 diabetes are only used to correct high blood sugar, when the better approach is to maintain good (lower) blood sugar levels. This may sound like the same thing, but it is not. You would not drive a car to a certain speed (55 miles per hour for example) and then take your foot off the gas pedal to maintain that speed. You shouldn’t do the same thing with your medications either – get to a good blood sugar level and stop. If you work with your health care team to adjust your medications and reach a target blood sugar level, continuing that dose is the best way to maintain good blood sugar levels and avoid the ups and downs that can occur with irregular medication use. If your blood sugars are going up and down despite taking your medications as prescribed, it is important to discuss this with your diabetes care team.
A second reason to continue your medications is that the heart and kidney protective effects of certain medications are only gained with long-term use. These benefits can save your life or prevent you from needing burdensome treatments like dialysis (where a machine does the work of your kidneys). Continuous use of these medications is definitely worth the effort.
Many people find that periodic or irregular use of medications leads to more side effects, because your body never gets fully used to the medication (for example, stomach discomfort that would normally lessen in a week or two).