Miss a Dose? What to Do If You Forget to Take a Type 2 Diabetes Pill

If you’re diagnosed with type 2 diabetes, your doctor may first prescribe either insulin or other medications to control your blood sugar. Your doctor may also discuss diet changes, exercise plans, and weight loss methods.

When these measures aren’t enough to bring your blood glucose levels down to the normal range, your doctor may prescribe another medication to lower these levels.

These medications work in different ways to lower blood glucose levels, including:

• reducing the amount of sugar released by your liver
• slowing down the absorption of sugars from the food you eat
• improving how your body responds to insulin
• helping your pancreas release more insulin
• preventing the reabsorption of glucose from blood filtered through your kidneys
• preventing absorption of the sugar from the gut

There are several types of oral medications for type 2 diabetes. Examples include:

• metformin
• alpha-glucosidase inhibitors, such as acarbose (Precose) and miglitol (Glyset)
• bile acid sequestrants, like colesevelam (Welchol)
• DPP-4 inhibitors, such as linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia)
• meglitinides, like repaglinide
• SGLT2 inhibitors, such as canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance)
• oral glucagon-like peptide (GLP-1) inhibitors, such as Rybelsus
• sulfonylureas, such as glimepiride
• thiazolidinediones, such as pioglitazone
• combination therapies that include two or more of the above medications

If your blood sugar levels have been within the normal range recently, and you’re following a healthy diet and lifestyle, then missing one dose isn’t likely a problem.

However, missing several doses or not adhering to diet and lifestyle modifications recommended by your doctor can lead to hyperglycemia (high blood sugar).

In general, glucose levels greater than 180 mg/dL 2 hours after the start of a meal, or over 130 mg/dL before a meal, are considered high. Symptoms of hyperglycemia include:

• tiredness
• blurry vision
• excessive thirst
• frequent urination
• sores that won’t heal

Missing doses of oral diabetes medications frequently can lead to serious health complications, some of which may require hospitalization. This also increases the overall cost of your treatment.

Potential complications include nerve damage, as well as eye, kidney, or heart disease. These conditions become worse the longer they are left untreated.

If you miss a dose of an oral medication, take the dose as soon as possible after realizing you missed it. However, if it’s been more than a few hours since the missed dose and you’re getting close to the next dose, skip the dose and take the next dose at its regular time. Don’t double the dose.

Next, call your doctor to ask about your specific medication and what they recommend.

Your medication or the website for your particular brand of medication also comes with a patient information packet that will let you know what to do if you miss a dose. It’s useful to keep this packet in a safe place.

It’s important to talk to your doctor if you have questions or concerns about your medication or you notice any new symptoms. You should call your doctor if:

You’re having symptoms of hyperglycemia

If you miss several doses and you begin having symptoms of hyperglycemia, call your doctor. Your doctor may want you to schedule an appointment for a checkup.

You’re skipping doses on purpose

Contact your doctor if you’re skipping doses of your medications on purpose due to side effects or costs. Your doctor can discuss other options with you for managing your diabetes.

There are many different classes of drugs available, and some may be more tolerable for you than others. There may also be less expensive options than the medications you’ve been prescribed.

Note that sometimes side effects are only noticeable the first few weeks after starting a medication. Sometimes, taking the medication with a meal helps to reduce uncomfortable gastrointestinal (GI) side effects that can occur in the first few weeks of treatment.

You’re forgetting your dose because you have too many pills to take each day

If you’re missing doses because you just have too many pills to take each day and it’s difficult to keep track of them, see a doctor to discuss your options.

Your doctor may be able to prescribe a combination pill that contains multiple medications. This will reduce the number of pills you have to take each day.

It can be difficult to keep track of your medications, especially if you take multiple drugs to manage type 2 diabetes and other health conditions. Here are a few tips and tricks to help you remember to take your medication.

• Organize your medications in pill boxes with separate compartments for each day of the week.
• Set reminders on your smart phone or other smart device.
• Log your medication on a chart attached to a wall or your refrigerator, or on a phone app. Search your app store for medication reminders.
• Take your medications at the same time each day while you do another routine habit, like brushing your teeth, making breakfast, or at bedtime.
• Leave your pill box on the bathroom counter in plain sight.
• Ask for help from a friend or family member.

You should also ask your doctor if taking the oral diabetes medication with a meal will reduce GI side effects. Fewer side effects can help you stick to your treatment regimen.

Diabetes medications are meant to be taken around the same time every day, so it’s important not to forget to take these medications on time.

Missing a dose of oral diabetes medications will likely cause an increase in blood sugar levels, but the amount it increases will depend on the number of carbohydrates you ate that day and your exercise levels.

Frequently missing doses can increase your risk for blindness, kidney disease, heart disease, and nerve damage.

If you miss a dose of your oral diabetes medication, take it as soon as possible. If it’s close to the time of your next dose, skip that dose and take the next one as scheduled. If you miss more than one dose, take it when you do remember.

Call your doctor if you start having any symptoms of hyperglycemia or if you have concerns regarding your medications.