The Ups and Downs of Meds and Diabetes (Part 5): Wrapping Up

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This week, I’ll wrap up my series of blog entries that have addressed varies types of medications and their effects on diabetes. I thought it might be worthwhile looking at some other drugs that can affect diabetes management.

Oral contraceptives: Birth control pills (otherwise known as “the pill”) were approved by the FDA back in 1960. Today’s formulations have lower doses of hormones and are considered to be quite safe for most women. Some even offer certain health benefits, such as lowering the risk for ovarian cancer and improving acne.

Many birth control pills contain a synthetic form of estrogen. Estrogen may cause blood glucose levels to increase somewhat by promoting insulin resistance. The effect is usually not enough to warrant an increase in diabetes medication; however, if you take birth control pills, it’s important to closely monitor your blood glucose levels.

Interestingly, some research points to an increased risk of cardiovascular disease (heart disease and stroke) in African-American women who use the pill, and other research indicates that use of the pill in women with diabetes may increase the risk of diabetic nephropathy. Neither of these findings means that women with diabetes should not take the pill, but it’s important to have a discussion of any medical risks while on the pill with your health-care provider.

Antipsychotic medications: Certain antipsychotic medications, used to treat mental illnesses such as schizophrenia, have been linked with increasing the risk of diabetes: Quetiapine (brand name Seroquel), aripiprazole (Abilify), olanzapine (Zyprexa), risperidone (Risperdal), clozapine (Clozaril), and ziprasidone (Geodon). These drugs are sometimes called “atypical” or “second generation” antipsychotics, and many have been shown to cause weight gain and worsen glucose tolerance.

These medications now come with a warning that anyone using them should be monitored for adverse effects on glucose levels. And because these meds are very effective at what they do, the message is to not necessarily stop taking them, but, as always, talk to your health-care provider if you have or are at risk for developing Type 2 diabetes.

Examples of other medications that may raise blood glucose levels:

  • Phenytoin (Dilantin)—antiseizure medication
  • Saquinavir (Invirase)—antiretroviral agent
  • Salmeterol (Serevent)—anti-asthmatic
  • Albuterol (Ventolin)—anti-asthmatic

Examples of other medications that may lower blood glucose levels:

  • Dicumarol—anticoagulant
  • Fluoxetine (Prozac)—antidepressant
  • Varenicline (Chantix)—smoking cessation aid
  • Quinine (Qualaquin)—antimalarial

Again, it’s important to remember that the two lists above are just partial lists. And, believe it or not, in some of the literature, certain medications are listed as raising blood glucose levels, whereas, on other lists, they are said to lower glucose levels.

Because this can all be confusing, keep in mind that you have an excellent resource at your fingertips, and that’s your pharmacist. Pharmacists are the experts when it comes to all medications, so be sure to ask yours if you have any questions or are confused about how any of your medications work.

Whenever you start a new medication, whether it’s temporarily, such as an antibiotic, or something more long-term, it’s a good idea to pay closer attention to your blood glucose levels. It’s not a bad idea to check your blood glucose levels more often, at least for a few days, if you start taking an over-the-counter medication, such as a decongestant, cough syrup, or dietary supplement, as many of these can affect blood glucose levels, too.

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