Do you find living with diabetes a bit of a challenge at times? It's not easy to control your blood sugar levels on a daily basis. However, with the new medications available today, it can be managed to a great extent. Today, we're going to talk about a special injection that your doctor may prescribe to help you control type 2 diabetes.
Simply put, what is this medicine?
This is actually a combination of two medications. That is, both insulin degludec and liraglutide are contained in this one injection. Your doctor may have given you this under the brand name `Xultophy`.
Simply put, the main function of this medicine is to reduce and control the level of sugar (glucose) in your blood. It is essential to follow your diet and exercise regimen while using this medicine. The best results can be achieved when all three are combined.
Things you need to tell your doctor before starting this medication
Before your doctor prescribes this medicine for you, he or she needs to have a complete picture of your health. Therefore, if you have any of the conditions listed below, be sure to tell your doctor about it. Don't hide these things, as it's for your own safety.
| Your health condition or problem | Why is it important to raise awareness about it? |
|---|---|
| If you have previously had pancreatitis. | This medicine may increase the risk of the condition recurring. |
| If you or a close family member has thyroid cancer or a condition called MEN 2, which causes tumors in the glands. | This information is very important because there is a very small risk of thyroid cancer associated with this medication. |
| If you have kidney or liver disease. | If this organ is not working properly, the dose of the medication may need to be changed. |
| If you have heart disease. | People with heart disease should be especially careful when taking this medication. |
| If your blood sugar levels are low (hypoglycemia). | Because this medication also lowers blood sugar, the risk may be even greater for someone who frequently has low blood sugar. |
| If you have digestive problems or stomach or intestinal problems. | This medicine can affect the digestive process. |
| If you are pregnant, trying to get pregnant, or breastfeeding. | In these cases, it is imperative to seek medical advice regarding the use of medication. |
| If you have allergies to any other medicine, food, or substance. | It is important to be aware of this as it is possible to have an allergic reaction to this medicine. |
How do you use this injection?
This should be injected under the skin. Usually, the abdomen, thigh, or upper arm is used for this. Your doctor or diabetic nurse will show you exactly how to inject this.
Very important: Never share your injection pen or needles with anyone else. Even if you change the needle, do not do so. Doing so could cause serious infections for you or the other person. Only one pen is for one person!
- Take it on time: Take your medicine exactly as your doctor tells you to, at the right time. Don't skip doses.
- Dispose of needles properly: Do not throw used needles in the trash. Put them in a sharps container. If you don't have one, ask your doctor about one.
- Read the information leaflet: When you are given a medicine, read the information leaflet (MedGuide/Instructions for use) that comes with it carefully. It contains a lot of important information.
What to do if you miss a dose?
It is not a good idea to skip a dose of this medicine. Talk to your doctor in advance about what to do if you miss a dose and make a plan for it. Never take a double dose to make up for a forgotten dose.
Can it interact with other medications?
Yes, it definitely can. Some medications you take can affect your blood sugar levels. Also, there are some medications that mask the symptoms of low blood sugar (hypoglycemia). This means that even if your blood sugar is low, you may not notice it. That's dangerous.
Therefore, tell your doctor about all medications you take (including vitamins and traditional medicines) .
| Nature of the impact | Examples of medications |
|---|---|
| Medications that can affect blood sugar levels | |
| Alcohol | Any type of alcohol. |
| Some antibiotics | Such as Ciprofloxacin, Levofloxacin. |
| Medicines for blood pressure or heart disease | Such as Enalapril, Lisinopril, Losartan. |
| Types of Steroids | Like Prednisone, Cortisone. |
| Other diabetes medications, hormones | Thyroid hormones, birth control pills. |
| Medications that can mask the symptoms of hypoglycemia | |
| Beta-blockers | Such as Atenolol, Metoprolol, Propranolol (often prescribed for blood pressure or heart rate control). |
Things to be especially careful about when taking this medicine:
- Be aware of low blood sugar (hypoglycemia): This is the most important thing. Be aware of the symptoms of low blood sugar (tremors, excessive sweating, feeling uneasy, restlessness, fainting, rapid heartbeat). Always keep some sugar (sugar cubes, glucose tablets, a toffee) with you. If you feel very unwell and lose consciousness, tell your family not to put anything in your mouth. If this happens, you should seek medical help immediately.
- Know your HbA1C level: Your doctor will regularly check your HbA1C blood test. This shows how well your blood sugar has been controlled over a 2-3 month period.
- Don't skip meals: Eating on time is very important.
- Wear a medical ID: Carrying a medical ID bracelet or card that identifies you as a diabetic and details about the medications you take can be very important in an emergency.
- Stay hydrated: Dehydration can be dangerous while taking this medication. So drink plenty of water. If you experience any symptoms like fever, vomiting, or diarrhea, call your doctor immediately.
Warning sign: If you develop a lump or swelling in your neck while taking this medicine, if your voice changes (hoarseness) and persists, if you have difficulty swallowing, or if you have difficulty breathing, see your doctor immediately.
What are the possible side effects?
Like all medications, this one can have side effects. Some are serious, some are common. The important thing is to be aware of these and take action quickly if necessary.
| Serious side effects that require immediate medical attention | |
|---|---|
| Severe allergic reactions | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing or swallowing. |
| Pancreatitis | Severe stomach pain that feels like it's going to the back, vomiting, and fever. |
| Severe hypoglycemia (low blood sugar) | Severe shaking, confusion, fainting, difficulty speaking. |
| Kidney injury | Decreased urine output, swelling of the legs and ankles. |
| Thyroid cancer symptoms | New lump in the neck, difficulty swallowing, change in voice. |
| Side effects that are usually not serious, but should be reported to your doctor if they persist | |
| Stomach upset, nausea | Bloating, loss of appetite |
| Headache | Sore throat, runny nose |
This list may not include all possible side effects. If you experience any unusual symptoms, please tell your doctor.
What if I take too much medicine?
If you think you have taken more medicine than you think, immediately call the National Poisons Information Centre at the National Hospital in Colombo, or go to the Emergency Department (ETU) of the nearest hospital.
How to store the medicine?
- Unopened pans: Store these in the fridge door. Do not store them in the freezer.
- In-use pen: Once in use, the pen can be stored at room temperature (below 30 degrees Celsius) or in the refrigerator for up to 21 days. Throw away any remaining pen after 21 days.
- Never freeze. Do not use the medicine if it is frozen.
- Keep away from direct sunlight and excessive heat.
Take-Home Message
- This medicine is a combination of insulin and another diabetes medicine. It helps control type 2 diabetes.
- Before starting the medication, you should tell your doctor about your complete health history, especially if you have had pancreatitis or a family history of thyroid cancer.
- Never share your injection pen with anyone.
- Be aware of the symptoms of low blood sugar (hypoglycemia). Always carry some sugar with you.
- If you notice a new lump or tumor in your neck, a change in your voice, or difficulty swallowing, don't take it lightly and see a doctor immediately.
- If you have any questions about this medicine, ask your doctor.
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