If lifestyle changes such as losing weight, eating healthy and engaging in regular, moderate physical activity aren’t managing your blood glucose levels, you may need medication to help reduce your risk for heart disease and stroke.
Your doctor will decide which medication(s) and treatment plan are right for you based on your:
- Physical condition
- Cardiovascular risk factors (high blood pressure or cholesterol)
- Response to medication
- Insurance coverage
Your doctor may prescribe a combination of medications to lower your blood glucose and reduce cardiovascular risk.
Sticking to your medication and treatment plan can prevent diabetes from progressing and cardiovascular disease.
When functioning properly, the pancreas secretes the ideal amount of a hormone called insulin, which helps the body’s cells take in glucose from the blood to use it for energy. In people with Type 1 diabetes, the pancreas doesn’t produce insulin. People with Type 2 diabetes produce insulin, but their bodies don’t use it properly. Over time, people with Type 2 diabetes may also produce less insulin.
Various types of insulin may be prescribed for both types of diabetes to help regulate blood glucose. Each are injected into the fat under the skin to reach the bloodstream. (Insulin isn’t available in a pill because it would break down during the digestive process.) You can inject insulin with a:
- Syringe: A needle connected to a hollow tube holds the insulin and a plunger pushes the insulin down into and through the needle.
- Insulin pen: A device that looks like a pen holds insulin with a needle tip.
- Insulin pump: A small machine worn on a belt or kept in a pocket holds insulin, pumps it through a small plastic tube and through a tiny needle inserted under the skin where it stays for several days.
Insulins differ by how they’re made, how quickly they work, when they peak, how long they last and how much they cost. They include:
- Rapid-acting insulin begins to work about 15 minutes after injection, peaks in about an hour and continues to work for two to four hours.
- Regular or short-acting insulin usually gets into the bloodstream within 30 minutes of injection. It peaks two to three hours after injection and is effective for about three to six hours.
- Intermediate-acting insulin typically gets into the bloodstream two to four hours after injection. It peaks four to 12 hours later and works for about 12 to 18 hours.
- Long-acting insulin reaches the bloodstream several hours after injection and tends to lower glucose levels fairly evenly over 24 hours.
Your doctor will work with you to determine the best type and dosage to manage your diabetes and fit your lifestyle. Some patients take insulin one or more times a day to regulate their blood glucose levels. Your health care team will educate you about how and when to give yourself insulin.
Possible side effects of insulin include low blood glucose and weight gain.
Medications to reduce cardiovascular disease risks
It’s important to know what medications you’re taking and why. In addition to insulin, your doctor may prescribe:
1. Medications to prevent heart disease and stroke
In the last few years, new medications have not only helped reduce blood glucose levels, but also helped prevent heart attack, heart failure or stroke. They may:
- Decrease the glucose produced by the liver.
- Slow the food moving through the stomach.
- Reduce absorption of glucose via the kidneys.
Learn more about these medications.
2. High blood pressure medication
If untreated, high blood pressure can damage blood vessels, the heart and other organs — ultimately causing death. Doctors may prescribe one or more types of medication to get blood pressure to the target range. Follow the medication regimen as prescribed, notifying your doctor immediately if you experience side effects.
While many patients must take medications indefinitely to control blood pressure, doctors may reduce your drug dosages once you reach and maintain normal blood pressure for a year or more. Typically, you can't stop treatment entirely. Coping with the inconvenience of medication is still much better than suffering a stroke or heart attack.
3. Cholesterol medication
In addition to eating a heart-healthy diet, achieving or maintaining a healthy body weight and engaging in regular, moderate physical activity, you may need medication to lower your cholesterol levels and reduce your heart disease risk. Your doctor will determine if you can benefit from one or a combination of medications.
Learn more about the types of cholesterol-lowering medications.
4. Aspirin therapy
Diabetes is a major risk factor for cardiovascular disease and stroke. So your doctor may recommend a low-dose aspirin regimen. Aspirin “thins” the blood and helps prevent blood clots from forming, which can block blood flow through arteries, especially when they’re already narrowed by a buildup of plaque.
Don’t begin aspirin therapy on your own — ask your health care provider.
Learn about aspirin and heart disease.
To help you and your doctor keep up with your medications, use this handy medicine chart.