Type 2 Diabetes: Living With Complications

Medications

You may be taking more than one oral medicine to treat your type 2 diabetes. You may be taking insulin by injection or through an insulin pump alone or along with oral diabetes medicine. Taking these medicines as prescribed can help keep your blood sugar levels within your target range. For information on these medicines, see the Medications section of the topic Type 2 Diabetes: Living With the Disease.

You may need to take:

• ASA. If you are age 21 or older, talk to your health professional about taking a low-dose ASA daily to prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease).⁸¹¹
• A diuretic, an angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker, or other medicine if you have high blood pressure or have protein in your urine. These medicines can slow or prevent further damage to your kidneys.
• Medicines for digestive problems. The type of medicine will depend on the problem you are having. For example, if you have gastroparesis, you may take metoclopramide (Metoclop), domperidone (available in Europe), or erythromycin.
• Non-prescription pain relievers, creams, or prescription oral or injection medicines if you have pain from peripheral neuropathy.
• Medicines such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) if you have erection problems. These medicines can make heart problems worse in some people, especially those who take nitrate medicines (such as nitroglycerin). Check with your doctor before taking any of these medicines.

Medication Choices

Medicines for some complications include:

• ASA after a heart attack or stroke or to prevent these.
• Statins such as atorvastatin (Lipitor), simvastatin (Zocor), or pravastatin (Pravachol), to help prevent heart attack or stroke.
• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) for diabetic nephropathy.
• Phosphodiesterase-5 inhibitors (PDE-5 inhibitors) such as Viagra, Levitra, or Cialis if you have erection problems. Check with your doctor before taking any of these medicines.
• Fibrates such as gemfibrozil (Lopid) or fenofibrate (Lipidil) to help lower triglycerides and increase HDL levels.

What to Think About

Keep your blood sugar levels tightly within a normal or near-normal range by taking your oral diabetes medicine (and, in some cases, insulin) as prescribed.

If you have high cholesterol, take cholesterol-reducing medicines (such as statins) to keep your LDL cholesterol level less than 2.0 mmol/L (80 mg/dL), your triglyceride level less than 1.5 mmol/L (130 mg/dL).¹³ If possible, the HDL cholesterol level should be more than 1.03 mmol/L (40 mg/dL) in men. Women may need an HDL level of more than 1.3 mmol/L (50 mg/dL).¹⁴ See the topic High Cholesterol.

If you have high blood pressure, take medicines to keep your blood pressure consistently below 130/80 mm Hg. If your systolic blood pressure is between 130 mm Hg and 139 mm Hg or your diastolic blood pressure is between 80 mm Hg and 89 mm Hg, you may try some lifestyle or behavioural therapy for 3 months before starting medicine.¹⁷ For more information, see the topic High Blood Pressure (Hypertension).

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Author:	Caroline Rea, RN, BS, MS	Last Updated: December 12, 2007
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism
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