Type 1 Diabetes: Living With Complications

Medications

Insulin prescribed for type 1 diabetes by an injection or through an insulin pump helps keep your blood sugar level tightly controlled and as close to normal as possible. You may also take:

• An angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker, or other medicine, if you have high blood pressure or small amounts of protein in your urine (microalbuminuria). These medicines can slow or prevent further damage to your kidneys if you have microalbuminuria, even if you don't have high blood pressure.
• Aspirin, if you've already had a heart attack or stroke or are age 40 or older and at risk for these conditions, unless there's a medical reason you shouldn't.⁵ Ask your doctor if taking aspirin might help you.
• Sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil (Levitra), if you have erection problems and don't have medical reasons why you can't take them. These medicines can make heart problems worse in some people, so you should not take them if you are taking nitrate medicines, such as nitroglycerin. Check with your doctor before taking these medicines. Also, you can try a device for improving erections before you try medicine.
• Medicines for digestive problems. The type of medicine will depend on the problem you're having. For example, if you have gastroparesis, you may take metoclopramide (Reglan) or erythromycin.
• Nonprescription pain relievers, creams, or prescription oral or injection medicines if you have pain from peripheral neuropathy.
• Statins (such as lovastatin and simvastatin) to help decrease "bad" cholesterol (LDL).

Medication Choices

For your diabetes:

Insulin

For some complications:

• Angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) for diabetic nephropathy or cardiovascular disease
• Aspirin after a heart attack or stroke or for prevention
• Medicines for erection problems (such as Viagra, Cialis, or Levitra). These medicines can make heart problems worse in some people, especially those who are taking nitrate medicines (such as nitroglycerin). Check with your doctor before taking these medicines.

What To Think About

Take cholesterol-reducing medicines, if you have high cholesterol, to keep your LDL cholesterol level less than 100 mg/dL. Or aim for keeping your LDL at 70 mg/dL, your triglyceride level less than 150 mg/dL, and if possible, your HDL cholesterol level more than 40 mg/dL in men. Women may want to consider an HDL of more than 50 mg/dL. For more information, see the topic High Cholesterol.

Keep your blood sugar levels within your target range. Your target range may be close to normal blood sugar levels. If you frequently have low blood sugar levels, call your doctor. You and your doctor may decide to make your target range higher than the normal range to avoid low blood sugar emergencies.

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Author:	Caroline Rea, RN, BS, MS	Last Updated: November 18, 2008
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism
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