People with diabetes can take several steps to reduce the risk of suffering symptoms related to polypharmacy. Many of these preventive measures are simple tasks that patients nonetheless often overlook.

Such tips include:

• Read labels carefully. Information about potential drug interactions and other side effects can substantially reduce risks related to polypharmacy.
  
  
• Use one pharmacy to fill all medications. Most pharmacies keep a database of a patient’s prescriptions. This helps the pharmacist spot potential drug interactions in the medications prescribed for a patient.
  
  
• Take medications exactly as prescribed. In addition, patients should ask a physician what to do if they accidentally miss a dose.
  
  
• Make a list of medications. These can provide important information for patients, physicians and pharmacists and help prevent potential drug interactions. Include all prescription and over-the-counter medications, supplements, homeopathic remedies and vitamins. Keep this list updated, and bring it (and all pill bottles) along during visits to physicians.
  
  
• Do not take glucose-altering substances without a physician’s approval. Many medicinal herbs and supplements may affect the level of glucose (blood sugar). These may include bitter melon, fenugreek, gymnema, vanadium, ginseng, karela, devil’s claw, licorice, ma huang, garlic, ginger, cinnamon and chromium. Some physicians may approve these as part of treatment plan, but patients are advised not to start taking them on their own.
  
  
• Be knowledgeable about medications. Patients should know the names and doses of their medications and why they take them. Drug reference books may be helpful and are available at libraries and bookstores.
  
  
• Learn which medications can affect diabetes. Drugs that can cause hyperglycemia, insulin resistance and secondary diabetes include corticosteroids, other immunosuppressives, estrogens, injected contraceptives, antiretroviral (HIV) drugs, beta blockers (a class of antihypertensives), diuretics, certain anticonvulsants, antipsychotics and chemotherapy drugs. Beta blockers can also increase the risk of glaucoma, an eye disease that is more common in diabetic patients than nondiabetics. Beta blockers may also block the symptoms of low blood sugar, making it more difficult to know when a snack is needed.
  
  
• Share drug information with all physicians. Patients should be sure to tell all physicians on their care team about medications prescribed by other physicians.
  
  
• Discuss possible drug interactions with a physician or pharmacist. Never take a new medication – prescription or over-the-counter – without first discussing it with an expert.
  
  
• Ask about the safety of aspirin. People with diabetes have an increased risk of heart conditions, and many people with cardiovascular risk factors are advised by their physician to take daily low-dose aspirin. However, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can impair kidney function and damage the stomach. People with gastrointestinal diseases such as peptic ulcers, or kidney conditions such as proteinuria, diabetic nephropathy or end-stage renal disease, are advised to ask their physician whether it is safe for them to take aspirin and other NSAIDs.
  
  
• Ask about drugs that serve more than one purpose. For instance, many people with diabetes have high blood pressure and have or are at risk for kidney disease. A physician may prescribe medicines such as ACE inhibitors or angiotensin-II receptor blockers to address both concerns. Other examples:
  
• • The cholesterol drugs known as statins may help prevent cataracts, delay age-related memory loss (dementia) and reduce the risk of certain cancers, according to recent research.
    
    
  • A recently approved medication combining a statin with a calcium channel blocker (type of antihypertensive) can fight two common conditions in diabetic patients.
    
    
  • A new type of antidiabetic agent called incretins has helped many people lose weight.
    
    
  • A biguanide (metformin), approved to treat type 2 diabetes, may also help prevent atherosclerosis and treat polycystic ovarian syndrome.
    
    
• Avoid combination medications, such as cold products that mix an antihistamine and a decongestant, if only one is needed. Instead, patients could ask a pharmacist for help in selecting the medication that treats their specific symptoms.
  
  
• Do not store different medications in the same container. This can lead to confusion about which drugs have been taken.
  
  
• Consult a physician before making changes in diet and exercise. Meal planning and physical activity influence control of glucose. Improvements in nutrition and activity may reduce a patient’s need for some medications, as determined by the physician.
  
  
• Have a sick-day plan in place for dealing with illnesses and the medications they may require.