Diabetics
The more over-the-counter medications, prescription drugs and supplements an older adult with diabetes uses to manage blood sugar levels and treat complications, the higher the risk for adverse side effects and dangerous drug-to-drug interactions.
Although it is important to review each medication or supplement and discuss possible complications with the prescribing physician or pharmacist, there are some medicines that carry a greater potential risk for older adults. Medications that create long-lasting effects in the body, act as muscle relaxants, provide narrow medical benefits or cause drowsiness are of special concern and should always be used with care.
What a Caregiver Can Do
As a caregiver, you can help lower the risks associated with multiple medications. The first step is to ask your doctor how you can keep your loved one’s medication list as short and simple as possible. You will want to:
- Make a list of all the prescription medicines and over-the-counter pills, creams and drops, herbal products and vitamin and mineral supplements used by your family member. Include the doses and how often each medicine or supplement is taken. Download medication form.
- Show this list to your loved one’s family doctor and to every specialist involved in their care. Ask the doctors:
- Are any of these medicines and supplements likely to create drug-to-drug interactions?
- Can any of these medications be safely dropped from the list because their benefits are relatively small?
- Are there newer, more effective medications with fewer side effects that could replace some of the drugs on this list?
To Further Alleviate Problems Caused By Multiple Medications, You May Also Consider:
- Treating some conditions with assistive devices or behavior modification before turning to over-the-counter or prescription drugs. Physical therapy, for instance, can reduce the pain caused by neuropathy and insomnia can often be successfully overcome with simple dietary and behavioral changes.
- Whenever possible, ask your doctor if a single drug can be used to treat several conditions. One example may be using an ACE inhibitor, which can both lower blood pressure and help protect the heart.
Appropriate Prescribing For Older Adults
You can reduce the risk of drug interactions in a family member by following these suggestions: 1
- Try non-drug approaches first when possible.
- Consider the possibility that the person’s symptoms are related to an adverse drug reaction, not an illness.
- When a new drug is prescribed, learn how to use it, when to use it, common side effects and any potentially serious adverse reactions. Also find out what to do if these side effects happen.
- Regularly review with the doctor all of your loved one’s medicines, including prescriptions, over-the-counter pills, creams and drops, herbal products and vitamin and mineral supplements. Encourage your family member to keep an up-to-date medication list or maintain it for them.
- Coordinate care with all specialists involved in treatment to avoid duplication of prescriptions.
- Regularly assess how well your loved one is responding to prescribed medications. Ask the doctor if your family member can discontinue any medicines that do not appear to be offering any benefit.
- When possible, ask the doctor to avoid prescribing medicines that have a high probability of causing serious side effects in older adults. Your doctor can look up the ‘Beers Criteria for Medications to Avoid in the Elderly’.
- When possible, treat several health conditions with a single drug. Ask your doctor about drugs that have the widest possible health benefits since they are often less toxic.
1. Adapted from Good CB. Polypharmacy in Elderly Patients with Diabetes. Diabetes Spectrum Vol 15, No 4