Diabetes is a global public health challenge. Experts predict that by 2050, an estimated 1.3 billion people will be living with diabetes, majority of whom will have type 2 diabetes. Those being treated for type 2 diabetes often require treatment for co-existing conditions associated with diabetes like high blood pressure and cholesterol.
The development of complications from poorly controlled blood glucose ,further adds to their medication regimen. The act of taking 3-5 different medications a day to manage one’s health is referred to as polypharmacy. Polypharmacy increases risk of medication interactions, often referred to as drug interactions.
What are drug interactions
Drug interactions refer to a situation where the effect of a medication is affected by the presence of food, other medications and certain medical conditions. The effect of the interaction can either increase or decrease the effect of the medication, leading to new side effects or even toxicity.
Types of drug interactions
Drug-Drug interactions
Refers to the effect that one medication has on another medication when given together. The interaction could either increase or decrease the effect of one of the medications or both medications.
One such example is the use of Metformin and Dolutegravir. Metformin is a medication used to treat type 2 diabetes and Dolutegravir is used to treat HIV. When used together Dolutegravir increases the amount of Metformin in the bloodstream , thus increasing risk of Metformin related side effects.
When used together the dose of Metformin should not exceed 1000mg (1gm) per day.
Drug – Food interactions
Interactions can also happen between medications and food. Food can delay the time it takes for certain medications to produce their effect. Certain foods can affect how certain medications work.
Grapefruit juice is a great example of this. Grapefruit interacts with a number of prescribed medications, including some statins. Statins are a group of medications used to lower Cholesterol. The interaction between some statins and grapefruit juice results in an increase in the amount of statin in blood, increasing risk of side effects like muscle pain.
Drug -Disease interactions.
Being diagnosed with certain medical conditions can affect how your body responds to certain medications. Individuals living with kidney disease for example may struggle to clear out certain medications from the body fast enough. Resulting in the accumulation of medication in the body leading to toxicity.
For this reason, certain medications like metformin cannot be used in individuals with advanced kidney disease, as metformin is cleared by the kidneys and accumulation of metformin could lead to the development metformin associated lactic acidosis a rare but fatal side effect of metformin.
Drug – Herb interactions
Herbal preparations can also interact with prescribed medications, affecting how the medications work and in some cases cancelling out the effect of prescribed medications.
One such example is St John’s Wort; this herbal preparation interacts with several medications used in the treatment of type 2 diabetes. When used together with these medications it reduces the amount of prescribed medication in the bloodstream, leading to uncontrolled glucose levels. Uncontrolled glucose level increase risk of diabetes related complications.
Knowledge about ones medications and awareness of drug interactions is important for individuals living with chronic health conditions like type 2 diabetes. Pharmacists are trained to identify and manage drug interactions. If you are unsure or before using any over the counter medication talk to a Pharmacist. Regular medication reviews can help identify potential problems with treatment.