Managing diabetes mellitus in a complex world: navigating the challenges of polypharmacy

Authors

  • Charis Liapi

DOI:

https://doi.org/10.60988/p.v37i2S.132

Keywords:

diabetes mellitus; comorbidities; polypharmacy; side effects; challenges

Abstract

Diabetes mellitus (DM) presents complex challenges for both patients and healthcare providers. DM can lead to a range of complications and often coexists with other comorbidities. The need to effectively manage these complications, coupled with the presence of comorbidities, contributes to polypharmacy in DM patients. Polypharmacy can increase the risk of adverse drug events and drug interactions. As most serious adverse effects of polypharmacy in DM patients arise from drug interactions, the importance of careful medication management is paramount. Physicians must consider individual patient factors and conduct thorough pharmacological assessments in order to prevent unwanted effects. Furthermore, medication errors are a significant concern, particularly in elderly diabetic patients who are often prescribed multiple drugs due to comorbidities. Adhering to the Beers Criteria as well as regular monitoring for drug-drug and drug-food interactions, side effects, and medication appropriateness is essential for the optimization of the treatment and the reduction of the risk of adverse events in DM patients.

Author Biography

Charis Liapi

Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
College of Pharmacy, University of Babylon, Hillah, Iraq

References

Sun H., Saeedi P., Karuranga S., Pinkepank M., Ogurtsova K., Duncan B.B., et al. IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res. Clin. Pract. 183, 109119, 2022. DOI: 10.1016/j.diabres.2021.109119

Yu M.G., Gordin D., Fu J., Park K., Li Q., King G.L. Protective factors and the pathogenesis of complications in diabetes. Endocr. Rev. 45(2), 227–252, 2024. DOI: 10.1210/endrev/bnad030

American Diabetes Association Professional Practice Committee. Comprehensive medical evaluation and assessment of comorbidities: standards of care in diabetes - 2024. Diabetes Care 47(S1), S52–S76, 2024. DOI: 10.2337/dc24-S004

Chow E., Clement S., Garg R. Euglycemic diabetic ketoacidosis in the era of SGLT-2 inhibitors. BMJ Open Diabetes Res. Care 11(5), e003666, 2023. DOI: 10.1136/bmjdrc-2023-003666

Bell D.S.H. Combine and conquer: with type 2 diabetes polypharmacy is essential not only to achieve glycemic control but also to treat the comorbidities and stabilize or slow the advancement of diabetic nephropathy. J. Diabetes Res. 2022, 7787732, 2022. DOI: 10.1155/2022/7787732

Boppana S.H., Syed H.A., Antwi-Amoabeng D., Reddy P., Gullapalli N. Atorvastatin-induced necrotizing myopathy and its response to combination therapy. Cureus 13(1), e12957, 2021. DOI: 10.7759/cureus.12957

Maeda K., Hisaka A., Ito K., Ohno Y., Ishiguro A., Sato R., et al. Classification of drugs for evaluating drug interaction in drug development and clinical management. Drug Metab. Pharmacokinet. 41, 100414, 2021. DOI: 10.1016/j.dmpk.2021.100414

Backman J.T., Filppula A.M., Niemi M., Neuvonen P.J. Role of cytochrome P450 2C8 in drug metabolism and interactions. Pharmacol. Rev. 68(1), 168–241, 2016. DOI: 10.1124/pr.115.011411

Fugh-Berman A. Herb-drug interactions. Lancet 355(9198), 134–138, 2000. DOI: 10.1016/S0140-6736(99)06457-0

2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J. Am. Geriatr. Soc. 71(7), 2052–2081, 2023. DOI: 10.1111/jgs.18372

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Published

10-10-2025

How to Cite

[1]
Liapi, C. 2025. Managing diabetes mellitus in a complex world: navigating the challenges of polypharmacy. Pharmakeftiki . 37, 2S (Oct. 2025). DOI:https://doi.org/10.60988/p.v37i2S.132.