Health Tips

18.3% of Malaysians are diagnosed with type 2 diabetes mellitus in 2019 alone. Among these people, many of them do not suffer diabetes alone. In addition to diabetes, they may also suffer from other medical conditions and are required to take various types of medications.

While taking medications is important for a successful treatment, some medications have the side effects of raising blood sugar level, thus worsening one’s diabetes control. It is useful to know what these medications are and have a thorough conversation with your healthcare provider. This certainly does not mean that you should stop taking the medications, but let your healthcare provider’s professional opinion guide you the right way forward. 

Ready? Here we go!

1. Corticosteroids (medication for inflammation)

Here we do not mean the topical steroid creams you apply to your skin, but the oral steroids tablet/capsule one ingests for more severe inflammation disorders, such as rheumatoid arthritis lupus or severe asthma. While corticosteroid is an amazing anti-inflammatory drug that is useful in many diseases, it is known to lead to poorer diabetic control among diabetes patients who were on steroid treatment. It also appears that the higher the dose of steroid treatment used, the blood sugar level for diabetic patients was also higher. 

Essentially, long-term use of steroids may make it harder for your body to process carbohydrates properly, which ultimately leads to higher blood sugar level. The mechanism by which steroids cause high blood sugar levels is multifactorial. One reason is that steroid use may stimulate the liver to produce more glucose (hepatic gluconeogenesis), prevent the fat tissue from taking up glucose and change the cell receptor functions. 

2. Beta-blockers (high blood pressure and heart medication)

Beta-blockers are commonly used for the treatment of high blood pressure and heart problems. However, they are thought to contribute to high blood sugar level by impairing the pancreas’s ability to secrete insulin,a hormone in human’s body that converts glucose to glycogen which in turn lowers blood sugar level. Atenolol, a common beta blocker, was shown to contribute to new-onset diabetes and to worsen high blood sugar in people with abdominal obesity (a.k.a ‘big belly’). Within 9 weeks of using atenolol, some patients have already experienced impaired fasting glucose. Other beta-blockers scientists found that may persistently raise blood sugar level include propranolol and metoprolol. Interestingly, carvedilol and nebivolol are exceptions, which both do not contribute to higher blood sugar level.

3. Thiazide and thiazide-like diuretics (high blood pressure medication)

Colloquially known as the ‘water pill’, thiazide diuretics are another common drug class for high blood pressure treatment. Examples of such medications include hydrochlorothiazide and metolazone. Study has found that hydrochlorothiazide has been implicated in contributing to new-onset diabetes among people who did not have diabetes before in as few as 9 to 18 weeks of starting hydrochlorothiazide.

4. Statins (cholesterol medication)

Statins are widely prescribed for lowering cholesterol. Many diabetic patients take statins to prevent future heart attack and cardiovascular diseases. In 2012, the US Food and Drug Administration (FDA) introduced warnings on statins to advise on the higher risk of higher blood glucose levels and memory problems associated with the medication.

Others

There are many other medications that may also worsen diabetes, they are:

• Protease inhibitors - treatment used for people with HIV and AIDS

• Calcineurin inhibitors such as cyclosporine,sirolimus, tacrolimus - treatment after organ transplantation to prevent tissue rejection by immune system

• Second-generation antipsychotics/atypical antipsychotics such as olanzapine and clozapine - treatment of schizophrenia and psychosis 

• Fluoroquinolones antibiotics (gatifloxacin) - treatment of bacterial infection

Always look out your blood sugar level

70% of Malaysians who died of COVID-19 suffered from diabetes. If that alone is not a good wake up call, just remember that uncontrolled diabetes can lead to many complications, including heart attack, stroke, kidney failure (which you have to go for dialysis) and many more. 

If you are a diabetic patient, remember to:

• Carry out physical exercise at least 30 minutes every day, or 150 minutes per week

• Adopt a low carbohydrate diet

• Always take your anti-diabetic medications as per your doctor’s instruction

• Monitor your blood sugar level according to your doctor’s instruction

• Attend regular health screening with your doctor annually. Important health screenings for a diabetic patient include blood test, eye acuity check, and foot screening. 

• Always consult your doctor before starting any medication, herbs or supplements.

Stay healthy! If you have any problems related to diabetes, do not hesitate to consult our healthcare providers on Doc2Us. 

Written by

Ms Joyce Toh