1. Consider lifestyle changes. Diabetes pills work best when used in conjunction with a healthy diet, exercise, and (if necessary) weight loss. In fact, lifestyle changes may lower -- or eliminate -- the need for diabetes medications.
2. Know the recommended blood glucose range. You'll know medications are working if blood glucose readings fall within the recommended range. Find out from the main diabetes care provider how often you or the person you're caring for should check blood sugar levels, and be sure to keep a record of the results. Generally speaking, a blood sugar reading before meals of between 70 and 140 milligrams per deciliter is desirable.
3. Know when it's time to take action. Find out from the diabetes doctor or educator how low or high blood sugar can go before it's important to take action. For many people, blood sugar is too low below 70 mg/dL and too high above 240 mg/dL. Make sure you know the signs of hyperglycemia and hypoglycemia and how to treat either condition.
4. Ask specific dosage questions. Ask the doctor the following questions about medications. Write the response down somewhere handy, such as a medication notebook.
- When should the person I'm caring for take his diabetes pills: before a meal, with a meal, or after a meal?
- How often should he take the medicine?
- Should he take the drugs at the same time every day?
- What should he do if he misses a dosage?
- What side effects may occur?
- What should we do if he experiences side effects?
6. Tell the doctor about all medical conditions. Most older adults have other medical conditions in addition to diabetes, including high blood pressure and high cholesterol.
Make sure the patient's main diabetes doctor is aware of all illnesses, chronic conditions, allergies, or surgeries, and work with his diabetes healthcare team to set treatment goals for his care that complement his overall healthcare.
7. Keep a current medication list. Older adults with diabetes are at an increased risk for drug side effects and drug interactions, especially as the number of medications increases. Make sure the person in your care keeps an up-to-date medication list and that he brings it with him every time he sees any healthcare provider. Include every prescription medication and over-the-counter drug, vitamin, and herbal or homeopathic treatment and their dosages.
For example, many common medications used to treat high blood pressure also raise blood glucose. Other drugs, either on their own or by interacting with oral diabetes drugs that lower blood glucose, can make diabetes remedies more potent and lower blood glucose to dangerously low levels.
If the person you're caring for starts on a new medication and suddenly finds his blood glucose is significantly higher or lower than usual, ask his doctor to check out the possibility that the new medication is causing the unwanted effect. It's also important to check blood sugar more often after starting on a new drug for this reason.
8. Stick with one pharmacy. If possible, use the same pharmacy for all prescriptions. By having a complete record of all medications, the pharmacist can alert you, the patient, and his healthcare providers to possible interactions.
9. Report any side effects. A patient should report any side effects from medications to his healthcare provider and include the following details: how long they lasted, how severe they were, and what medications and what dosages he was taking at the time.
10. Compare prices. Costs can vary widely for different drugs at different places. Call around to a few pharmacies to find the best price for the pills, and ask your regular pharmacist to match a cheaper price if necessary. Some diabetes drugs are available in generic form; check with the pharmacist.
11. Check tablet strength. Another money-saving tip: Ask the doctor to prescribe the largest tablet strength suitable for the dose the patient needs. For example, a 500-milligram pill often costs much less than two 250-mg tablets. Use a pill splitter, available at drugstores, to cut the larger tablet into the appropriate dose (halves or quarters). One word of caution: Some extended-release drugs don't work properly if they're split, so always check with the pharmacist or doctor before cutting tablets.
12. Keep track of daily medications. Use a pillbox or some other system to keep track of daily drugs. Ask the pharmacist for suggestions and see our article "How to Help Someone With Diabetes Follow Medication Recommendations".
13. Throw out old drugs. Get rid of (by recycling if possible) outdated medications and those left over from prescriptions the person you're caring for no longer uses. Old drugs may lose their potency or interact with pills he's currently taking.
14. Know that drug types and dosages may need to change over time. Diabetes is a progressive condition, meaning it continues to change over time as a patient's insulin production steadily declines. The dose and type of pills most patients use to control the disease may need to be adjusted to reflect these bodily changes.
15. If at first you don't succeed. No one diabetes drug is best for every person, and what works for one person may not work for another. A patient's main diabetes doctor and others on his team can help him find diabetes medicines that best meet his overall treatment goals
