Patients who have been diagnosed with diabetes mellitus should regularly take hypoglycemic drugs to effectively control blood glucose levels (the frequency and duration of taking this or that medication is prescribed by the doctor). Diabetics are mainly elderly people with several chronic diseases, so they have to take several medications every day . Age-related memory impairment and a large number of drugs taken are the main reasons for a violation of the scheme of taking antihyperglycemic drugs.
What to do if you miss your antidiabetic medication? Let’s consider in detail.
Missed intake of biguanides
Most often, in diabetes mellitus, the drug Metformin (from the biguanide family ) is prescribed . It has no effect on insulin secretion and, as a rule, is not the cause of hypoglycemia. Skipping Metformin intake may affect 2 hours after a meal.
If your blood sugar is slightly elevated, you can correct it by increasing the amount of exercise (without consuming the missed dose).
If your blood glucose level has increased significantly, you need to take the missed dose as soon as you remember. If you remembered the next time you take Metformin , then you do not need to take the missed dose.
Skipped taking sulfonylurea derivatives
All drugs belonging to this group are divided into 2 categories: short-acting and prolonged-acting drugs. Short-acting drugs ( Gliquidone , Glipizide , etc.), as a rule, must be taken before meals.
If you remembered about them while eating, then it is better to postpone the meal for a while. If you think of the drug between meals, check the random blood glucose level – if the level is slightly elevated, you can simply skip the dose.
If you remember that you forgot to take your medication by the time of your next meal, you can take the forgotten medication just before eating.
Measure your fasting blood glucose:
- if fluctuations in values are not obvious, then take the drug in accordance with the recommended dose for you without any changes;
- If your fasting blood glucose level rises significantly, you can temporarily increase your pre-meal dose or decrease your meal volume so that your blood sugar returns to normal as soon as possible.
You should never add the previous missed dose of the drug to the next, so as not to cause a sharp drop in blood sugar levels.
This group includes the drugs Repaglinide and Nateglinide . If you skip taking them, you need to act, as in the case of sulfonylurea derivatives .
If you remember about the medicine right after a meal, you can take the missed dose immediately. If you remember about it between meals, then use it before your next meal.
Consideration should be given to reducing the missed dose based on your blood glucose results. If on an empty stomach it slightly increased, then there is no need to change the amount of medicine and food.
If the blood sugar level has increased significantly, then the dosage should be increased or the food volume reduced accordingly – the blood sugar level will return to normal and reduce the effect of missing the medication.
Missing alpha glucosidase inhibitors
This class of drugs includes Acarbose ( Glucobay ), Voglibose ( Woglib ), and the like. Such drugs, first of all, delay the intestinal absorption of carbohydrates and lower blood sugar levels (mainly that which occurs immediately after a meal).
It is necessary to take drugs of this group during breakfast. If you find that you have missed a dose, you should immediately take the missed dose with a meal. If you remember skipping the medication after a meal (within half an hour), then you should also immediately take the initial dose, but the effectiveness of the drug will be significantly reduced (patients can compensate for the lack of effectiveness through physical activity). In this case, the patient should check the glucose level: if its level is not much higher, it can be corrected by increasing the amount of exercise; if the blood glucose level has increased significantly, then it is worth taking other short-acting glucose – lowering drugs.
Missed insulin sensitizers
Representatives of this class are Rosiglitazone ( Avandia , Donatello) and Pioglitazone . These medications need to be taken once a day. If only one drug is prescribed, if you miss it, you can take the drug at any time of the day in the prescribed dosage.
Skipped DPP-4 inhibitors
The drugs Sitagliptin , Saxagliptin , Vildagliptin , linagliptin , Alogliptin belonging to this class increase insulin secretion during inhibition of glucagon secretion, as well as delay the rate of gastric emptying, and cause weight loss. The drugs are quite safe because they do not cause hypoglycemia. In the event of a missed appointment, patients can take the medication when they remember about the missed appointment.
How not to miss your medication?
Regular intake of hypoglycemic agents and adherence to diet are very important factors in smoothly regulating blood glucose levels and reducing the risk of developing complications of diabetes mellitus. Therefore, people with this disease should attach great importance to the timely intake of antihyperglycemic drugs.
- Keeping the antidiabetic medication in plain sight at all times (for example, on the table, next to a cup or plate) is more difficult to forget about.
- Record your medication time to avoid mistakes.
- If you are working, always carry anti- hypoglycemic products for daily use in your bag or pocket , so that you don’t forget to take them when you go out to dinner. Write down the time you take your medication on a leaflet, and carry that leaflet with you as well.
- Elderly patients with diabetes can use delayed-release tablets of the active ingredient when skipping drugs : Gliclazide , Glimepiride , Metformin . These drugs are taken once a day, and it is more difficult for the patient to forget about them.
Remember that your body is your property, and only you are responsible for your health. Give your body what you owe it on time!