Best Time To Take Medication? – Diabetes Type 2

“Doctor, I was just playing around with my medication, and you told me to move it before dinner time, and that actually helped my blood sugars, so after a few weeks, […]

“Doctor, I was just playing around with my medication, and you told me to move it before dinner time, and that actually helped my blood sugars, so after a few weeks, I moved it to lunchtime, and my sugars improved even more, so I’m now taking it at lunchtime” True words from Margaret who has diabetes and has been working on a very “light” Time Restricted Eating Regimen. I asked her to start simply by cutting back her eating time to end at 6pm.  This evened out those peaks in her blood sugar, she’s 67 years old and didn’t want to be burdened with having to take more medication, so she was motivated to begin life habits that work. Having no side effects to curbing her eating time back to 6pm, we also moved her medication from bedtime to before dinner.  Your body’s circadian rhythm can actually augment how your medication works depending on what time you take your medication!

Typical Diabetes Type 2 medications are prescribed as a once a day or twice a day regimen or three times a day, without any guidelines as to what Time they ought to be taken.  Given the generous leeway of “When” medication should be taken, can be used to our benefit if you understand your Circadian Rhythm Genes. For example a typical medication, glyburide is labeled for once a day dosing.  Someone may take their medication at 8am with breakfast, while someone else may take their at 11pm closer to their bedtime.  Will there be a difference in effectiveness for each of these individuals? Yes!

Does this loose recommendation of dosing, as far as timing make a difference in the effectiveness of the medication? Circadian biology is demonstrating how our bodies operate on time, so the activity of your organs is very different at different times of day, which means medication can have a different effect on your body at different times of the day.  This has a HUGE impact on blood sugar and the time of day/night they take their medication.  Animals studies have already demonstrated that for metformin, one of the most commonly prescribed diabetes medications, taking it during the late morning improves the effectiveness of the medication in lowering blood sugar, rather than closer to bedtime.

Margaret was taking her metformin medication at bedtime, and when she moved her medication to right before dinner, rather than at bedtime, she had improved blood sugars, because she was activating her own circadian rhythm.  This does go against conventional assumptions on the linear effect of medication, and this is where an entire movement of science is heading.

After these changes Margaret says “I don’t know why but it helped my blood sugars even more” Time Restricted Eating brought her fasting blood sugar down by more than 10 points and then, when she made that shift from pre-dinner to pre-lunch medication, she dropped her morning fasting numbers by another 10 points, bringing her in to the range of 110’s fasting – IDEAL!  I didn’t realize that competition even exists in the world of diabetes, as Margaret pulled a small sheet of paper from her purse and showed me her girlfriends fasting glucose numbers and her hemoglobina1c (anonymously of course) and compared with her own numbers now, Margaret’s numbers were seriously better than her friends!  Margaret just smiled.  Her improvement was solely based on changing the timing, the timing of when she eats, as she also applied Time Restricted Eating to her daily schedule, and when she takes her medication.

We can thank the scientists and researchers in the field of Circadian Biology for their dedication, in helping us to better understand our genes, so that we can harness them in a way to improve our health – dramatically…an hour at a time.

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