Busting the myths about diabetes: A pharmacist’s guide to the facts

Published on 14 February 2025

Think diabetes medications harm your kidneys or lead to dependency? Think again. Here’s why they are safe, effective and lifesaving.

“It’s normal to be scared. But get to know your medication – by its name, not just appearance. Understand how it works and how it will benefit you. Then you’ll know there’s less to worry about."

This is the advice that Dr Golda Wang, Principal Clinical Pharmacist at Alexandra Hospital, shares with patients managing Type 2 diabetes.

Living with a lifelong condition like diabetes is challenging. It requires patients to adopt new habits while addressing their fears about medication. Many of these fears stem from myths about diabetes treatment, which can lead to unnecessary delays in starting effective care.

Here, Dr Wang tackles some of the most common misconceptions about diabetes medications and explains how they support better health.

Myth 1: Diabetes drugs harm your kidneys

One of the most widespread concerns is that metformin, a commonly prescribed drug, damages the kidneys.

Metformin is processed by the kidneys and excreted in urine, which is why some patients think it harms kidney function. However, this is a misconception. “Metformin does not cause kidney damage,” Dr Wang said.

In fact, research consistently shows that metformin is effective in managing blood sugar levels and does not harm the kidneys in otherwise healthy individuals.

The only exception is for individuals with severe kidney disease, as their kidneys may struggle to clear the drug. In these cases, alternative treatments are used.

Myth 2: Taking insulin means you’ve failed

Another misconception is that needing insulin or additional medications is a sign of failure or dependency.

For Type 2 diabetes, the body’s ability to produce or use insulin effectively decreases over time. It is a natural progression of the disease – not a reflection of the patient’s efforts.

“Insulin is simply a tool to help your body manage blood sugar and prevent complications,” Dr Wang said. “Needing insulin doesn’t mean you’ve failed or become dependent.”

Myth 3: Supplements are as good as medication

Another pervasive misconception – and a dangerous one – is that traditional supplements are just as beneficial as prescribed medications and can therefore replace them.

While supplements may offer general health benefits, they can contain impurities or unverified ingredients that may harm your health. They also lack the rigorous testing and regulation applied to medications. This means their safety and effectiveness cannot always be guaranteed.

Relying solely on supplements can delay effective treatment, worsening blood sugar control and increasing the risk of complications like nerve damage or heart disease.

Prescribed medications, on the other hand, are designed specifically to target different pathways to lower blood sugar, Dr Wang explained.

How diabetes medications actually work

In a nutshell, Type 2 diabetes occurs when the body struggles to control sugar (glucose) levels in the blood, said Dr Wang.

Insulin, a hormone, moves sugar from the blood into cells for energy. But when insulin does not work properly or is not produced in sufficient amounts, sugar builds up in the bloodstream.

This can cause fatigue and, over time, damage to organs such as the heart, kidneys and nerves.

Dr Wang described diabetes medications as working like a “lock-and-key” system:

-       Type 2 diabetes jams the cell “lock”, preventing sugar from entering. 

-       Insulin acts as the “key” to open the cell and allow sugar to be used for energy.

-       Medications like metformin help the key – or insulin – work better, ensuring sugar doesn’t build up in the blood.

These treatments help regulate blood sugar levels and prevent long-term complications.

Managing side effects

While effective, diabetes drugs can cause side effects. Common ones include bloating, diarrhoea and low blood sugar (hypoglycaemia), which may occur if medication doses are too high.

Certain medications, like SGLT2 inhibitors, can also increase sugar excretion through urine. This helps lower blood sugar levels, but may raise the risk of urinary tract infections, particularly in women.

“Side effects are usually temporary or manageable,” Dr Wang said. Patients can mitigate these issues by starting with lower doses, taking medications with food and staying hydrated.

If symptoms persist, patients should consult their healthcare provider to adjust treatment plans or explore alternative options.

Living well with diabetes

Effectively managing diabetes involves more than just medications. Dr Wang encourages patients to adopt a holistic approach that includes lifestyle changes and open communication with healthcare providers.

“The good news? Type 2 diabetes can be managed with healthy eating, exercise and sometimes medication,” she said. “Speak to your pharmacist to get advice tailored to your medical profile.”

She also recommends using trusted resources like HealthHub, which provides detailed information about medications, side effects and coping strategies in multiple languages.

With the right combination of treatment, lifestyle adjustments and professional support, managing Type 2 diabetes can become much easier.

Dr Wang’s message is simple but clear: “Don’t be afraid of your medications – they’re here to help, not harm.”

In consultation with Dr Golda Wang, Principal Clinical Pharmacist, Alexandra Hospital.