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Daniel Wai Diabetes,
Thyroid and Hormone Clinic Pte. Ltd.

DOCTOR'S NOTES

Will taking too much medication for diabetes/high blood pressure/cholesterol harm my kidneys or liver?

No it won’t.

Before any medication is allowed to go on to the market, the medicine must be shown to have benefits (reduce blood pressure, blood sugar, cholesterol and/or prolong life) and does not cause any harm to the heart, liver and kidneys. Government organizations like the FDA and HSA in Singapore also monitors for new problems that are caused by medication. In this day of instant news and social media, these are often known by everyone immediately.

A lot of my patients are told by their friends that taking the medication “for too long” will harm their kidneys and liver. That is not true. Studies in patients with diabetes such as the ADVANCE[1] and STENO-2 [2] had consistently shown that having better control of chronic diseases such as diabetes, high blood pressure and cholesterol are good for patients. These benefits extend over many years. The better the control of their illness (i.e. more medication they take), the lower the chance of heart attacks, strokes, eye problems, kidney problems, and premature death. On the other hand, when patients with diabetes do not take their medication as instructed by doctors, their control of diabetes, blood pressure and cholesterol worsened, leading to 58% more hospitalization and 81% increased chance of dying [3].

With advances in medicine, we now have many effective types of medication allowing us to control chronic diseases much more effectively [4]. From year 1997 to 2006 in America, death in patients with diabetes dropped 23%, and death from heart attack and stroke dropped 40% [5].

The evidence is overwhelming. Taking more medication did not lead to problems. In fact, the opposite is true.

A lot of people may not realize that the regional flavored rice are all high in energy. Hainanese chicken rice is cooked with chicken soup; nasi lemak and nasi kuning are cooked in coconut oil; nasi briyani is first fried with ghee or oil, then steamed in chicken or mutton stock! White rice has much less energy, and brown rice is certainly even better.

An important note: All medications have side effects and some are not suitable for patients with existing kidney and liver failure. So talk to your doctor for the best medication for you.

1: ADVANCE Collaborative Group. Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 DiabetesN Engl J Med 2008;358:2560-72.

2: Gaede et al. Multifactorial Intervention and Cardiovascular Disease in Patients with Type 2 DiabetesN Engl J Med 2003;348:383-93.

3: Ho et al. Effect of Medication Nonadherence on Hospitalization and Mortality Among Patients With Diabetes Mellitus. Arch Intern Med. 2006;166:1836-1841

4: Casagrande et al. The Prevalence of Meeting A1C, Blood Pressure, and LDL Goals Among People With Diabetes, 1988–2010. Diabetes Care. 2013 Feb 15. [Epub ahead of print]

5: Gregg et al. Trends in Death Rates Among U.S. Adults With and Without Diabetes Between 1997 and 2006Diabetes Care 35:1252–1257, 2012