Diabetes drug use linked to unnecessary additional medications, study finds

Researchers examined healthcare data from over 387,000 participants to investigate how often individuals with type 2 diabetes require additional medications to address adverse effects from their initial prescriptions. The findings, published in BMC Medicine, revealed a pattern of what’s known as “prescribing cascades,” where a second drug is added to manage side effects mistakenly interpreted as new medical conditions.

Seven potential prescribing cascades were identified among 12 medication pairings analyzed. Two prevalent diabetes medications, sodium-glucose cotransporter-2 (SGLT2) inhibitors and thiazolidinediones, were notably involved.

SGLT2 inhibitors, which work by increasing glucose excretion through urine, can cause increased urination, dizziness, and a higher risk of yeast infections. The study found these medications were often followed by antibiotics, antifungals, and medications for overactive bladder.

Thiazolidinediones, which improve insulin sensitivity, can lead to leg and ankle swelling, weight gain, and an increased risk of bone fractures, heart failure, liver damage, or low blood sugar. Patients taking these medications were frequently prescribed loop diuretics to address the swelling.

Other common diabetes medications, including statins and calcium channel blockers, also contributed to these prescribing cascades. Statins can cause urinary tract issues and sleep disturbances, while calcium channel blockers can lead to leg swelling, often treated with diuretics.

The researchers suggest that recognizing and addressing these drug-induced side effects by potentially modifying or discontinuing the initial medication could reduce the overall treatment burden and medication load for patients.