Taking over-the-counter medications is a common, and often, cheap and quick way of dealing with a medical problem. Self-medication, on the other hand, is the practice of taking medicines for a disease without consulting a proper medical practitioner. People, including those with diabetes, opt for self-medication because of a variety of reasons including cost, a friend’s recommendation, etc. Regardless of the reason, this practice of taking medications without prescription—be it allopathic, herbal, or food supplements [1]—can be very harmful.
One study found that as many as 40% of persons with diabetes self-medicate. [2] Interestingly, both men and women are equally likely to self-medicate, and the level of education did not considerably tip the scales either. What did cause an individual to resort to self-medication was one (or more) of the following reasons:
1. Mistrust of doctors
Patients who tended not to trust doctors had a higher frequency of taking anti-diabetes medications without medical supervision.
2. Recommendations by a family member or a friend
Often, patients would try a medicine based on the recommendation of their friends or family, particularly those who may also have diabetes and are taking a certain medication. This practice can be harmful because that medicine may not be fit for that patient.
3. Busy work environment
Patients who believe that they are too busy to visit doctors or go for medication refills have a higher risk of self-medication. This increases the risk of complications as regular checkups do not happen. Also, some patients might go to online pharmacies of a dubious repute, which incurs the additional risk of the medicines being fake or containing unregulated impurities.
4. Medical expenses
Some individuals tend to self-medicate in order to avoid the high cost generally associated with doctor consultations.
5. Longer duration of diabetes
Management of the diabetic condition is life-long, and this long duration indirectly leads individuals to fall in the self-medication pit, partly because of increased expenses over time and partly because of frustration with the long-term nature of the disease and lack of relief of symptoms.
Why is self-medication a bad idea?
Self-medication can be harmful. Non-prescribed medications are not customised to the patient’s overall condition, which may do more damage in the long run than provide benefit. In addition, physicians generally tailor the dose (how much) and the dosage (when and how often) of a medication depending on how the individual responds to it; this personalisation is lost when medical supervision is not sought. Additionally, there are risks of potential side effects of a medication and its cross-reactions with other medicines. Indeed, mixing medicines without medical supervision (even, for instance, one prescription medicine with another over-the-counter medicine) may usher in severe complications due to harmful interactions of the two medicines, known as drug-drug interactions. Studies have shown that 1 out of every 7 older adults who mix medicines in such a way is at a danger of a major reaction. [3]
A very common misconception is that herbal medications are free of side effects, which prompts many people all over the world to at least try them. Although there is evidence that some of them do work, taking them without any regulation or supervision equals risking side effects. Check out our article on the perils of herbal self-medication in diabetes.
Most developing countries such as India do not have a strong pharmacovigilance system, and pharmacists at local chemists and drugstores play little role in health screening and local health promotion. This makes follow-up visits to the doctor imperative. By avoiding visiting the doctor, monitoring the disease progress becomes challenging or downright impossible. You may not know if you are doing fine and need to lower the dose or if your condition is worsening and requires additional tests and preventive measures to prevent potentially debilitating complications.
Avoiding self-medication
While harmful even for individuals with a relatively minor disease, taking or mixing medicines without medical supervision can be hazardous for patients with diabetes (as well as those other more complicated diseases). Do not take medication based on what your friend, family member, or media has to say. If a certain medication does sound good, consult your doctor for advice. It may not be feasible to have a lengthy discussion, but explain why this is important to you and ask their opinion on switching and combining medications. Good management of diabetes, in which medicines play a significant role, can prevent or at least delay the onset of complications. It is worth spending both time and money on regular visits and checkup now than having to get regularly admitted for dialysis in the future. Always make sure to ask your doctor about all your queries and doubts.
References:
- You JH, Wong FY, Chan FW, Wong EL, Yeoh EK. Public perception on the role of community pharmacists in self-medication and self-care in Hong Kong. BMC clinical pharmacology. 2011;11(1):19. Available at: https://bmcclinpharma.biomedcentral.com/articles/10.1186/1472-6904-11-19
- Rezaei M, Safavi AR, Alavi NM, Kashefi H. Study of Self Medication In Patients With Diabetes Using Path Analysis. Journal of Diabetology &58; Official Journal of Diabetes in Asia Study Group. 2015;6(3):2. Available at: http://www.journalofdiabetology.org/temp/JDiabetol632-8622245_235702.pdf
- Qato DM, Wilder J, Schumm LP, Gillet V, Alexander GC. Changes in prescription and over-the-counter medication and dietary supplement use among older adults in the United States, 2005 vs 2011. JAMA internal medicine. 2016;176(4):473-82.
