Today, prescription medications for diabetes and testing supplies account or a significant amount of money for diabetics. Unfortunately, despite awareness of the complications of diabetes, many patients fail to achieve proper control of their A1c. Further some of the older diabetic drugs are also associated with low blood sugar (hypoglycemia) which often leads to non-compliance. When the diabetic drugs are discontinued by the patient, this is also associated with complications and even death. So newer drugs to treat type 2 diabetes should be beneficial.
In the last two decades many newer anti-diabetic drugs have been developed. In general when there are more drugs, diabetic patients have more options. Healthcare providers select anti-diabetic drugs based on safety, effectiveness and tolerance. Because each patient responds differently to a drug, the type of drug given to diabetic patient also varies. The chief advantage of the newer anti-diabetic drugs over the older drugs is that they are better tolerated. In addition, the newer diabetic drugs require less frequent dosing and also tend to have fewer adverse effects. Given the fact that some diabetics tend to be non-compliant with the older medications, the newer drugs are a welcome addition.
So one question that is often asked is “why are the newer anti-diabetic drugs not prescribed more often?”
The problem is the cost of these drugs; many health plans do not cover the entire cost and even when they do, there are high deductibles or co-payments. Some of these drugs are 2-10 times more expensive than the older anti-diabetic drugs.
The other reason why these newer anti-diabetic drugs are not the first choice is because no one has shown them to be more effective in lowering blood sugars than the older anti-diabetic drugs. For the majority of patients with diabetes, the older generic medication like metformin is just as effective and is well tolerated. Therefore when it comes to the treatment of diabetes, more is not always better.
Further, the consumer should also know that newer is not always more effective. The majority of diabetics will do fine with the lower cost older medications like metformin, which has been around for at least 70 years. Metformin has withstood the test of time and is the first drug of choice for all type 2 diabetics. It is relatively safe, has few side effects, and is very affordable. Drugs like metformin have a definite advantage for many diabetics. In fact there are even data to show that the drug also helps reduce weight. At a time when the cost of prescription medications have been astronomical, one always has to consider economics when taking a medication.
The other important fact is that many of the newer anti-diabetic drugs have only been out for a decade and many have not been fully tested. There continue to be reports about unusual side effects of these agents. Post marketing analysis is not complete with many of these newer drugs and their long term safety is still being evaluated. While some may prove to be safe in the long run, until that day arrives, diabetics should not consider these newer medications as a first option.
Irrespective of the diabetic drug selected, the treatment of diabetes is multifaceted. The disorder is associated with serious life and limb threatening complications if the blood sugars are not controlled. Hence all diabetics should change their lifestyle, incorporate exercise, eat a healthy diet, discontinue smoking and limit the amount of alcohol intake. Finally, a regular visit to the healthcare provider for a thorough check up is also recommended.
