AskNadia: Do Opiates Affect People With Type 2 Diabetes
Nadia:
Do opioids (painkillers) have a definite effect on people with type 2 diabetes? I’ve read that it makes you fall off the healthy wagon of eating right. But do the pills directly affect the effectiveness of insulin to control and manage blood sugar? Do opiates raise someone’s blood sugar or restrict the full potential of a diabetes pill that the doctor has prescribed?
Fernando
Dear Fernando:
Yes, opioids can negatively affect a type 2’s diabetic condition. However, most studies of the relationship between opioids and diabetes focus on substance abuse. So it’s important to distinguish between people with diabetes who take a prescribed opioid to control the pain generated by diabetic neuropathy or the effects of obesity, and people who have become addicted to opioids and use them to produce an altered state of consciousness.
Researchers have learned that opioid-dependent individuals have a higher A1c than non-opioid users. (There is even some speculation that opioid addiction can lead to type 2 diabetes. However, more studies are needed to prove or disprove it.)
Among the effects opioids can have on diabetic patients is an altered sense of time, which can affect their medication schedules. For example, forgetting to take insulin, which can lead to hyperglycemia. Or taking too much insulin and making themselves vulnerable to hypoglycemia.
Other unwanted side effects from opioids are altered eating patterns that can lead to obesity. One study says that some opioids can create a yearning for sweet foods—a circumstance that not only invites weight gain, but can also lead to tooth decay—a condition that endocrinologists warn makes diabetes more dangerous because of the proximity of teeth to the brain.
One way type 2s who are taking opioids can protect themselves is to find other type 2s who also take opioids and form a mutual support group. Members can monitor and remind one another of sticking to medication schedules and can check in with the group if opioid-related problems emerge.
Regarding opioids’ effect on type 2 medications, such as Byetta, or Januvia, or Victoza, they are only indirect. It is the possibility of opioid-induced forgetfulness or cravings that work against a type 2 medication, not opioids’ direct effect on a medication.
There alternatives to opioid painkillers. Aside from the usual over-the-counter drugs like aspirin, Aleve, ibuprofen, etc., some antidepressant drugs, such as nortriptyline, have been found to have a beneficial side effect as a painkiller for neuropathic pain. (Even though their primary use is the treatment of depression in certain patients, their secondary use as painkillers does not affect a non-depressed diabetic user’s moods or temperament.)
I hope this helps, Fernando. I’ve provided some links below that can give you a more detailed answer.
Nadia
Useful Links:
Disclaimer:
Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professionals’ therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.
About Nadia:
Nadia was not only born into a family with diabetes but also married into one. She was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, she co-founded Diabetes Interview, now Diabetes Health magazine.
Nadia holds 14 nominations for her work as a diabetes advocate. Her passion for working in the diabetes community stemmed from her personal loss—a mother and a brother who both succumbed from the effects of type 2 diabetes. She has used her experience as a caretaker to forge a career in helping others.
