Diet or drugs to treat diabetes?

Here at DMP, getting questions about diet and drugs is common.

We get asked things such as:

• Can type 2 diabetes be controlled by diet alone?
• Can I prevent from going on medication?
• As my numbers continue to get better…at what point can I cut back on medication and how?
• Could having a proper balanced diet and exercise eradicate the use of drugs to control type 2 diabetes?

These are all important questions so let’s tackle them one by one and assess whether diet or drugs should be used for type 2 diabetes treatment.

Can type 2 diabetes be controlled by diet alone?

Yes, in many cases type 2 diabetes can be controlled by diet alone. 

In fact, research indicates that dietary modification can be as effective, if not more effective than commonly available diabetes medications such as Metformin. 

When you consume the right type of foods that support good blood sugar and A1c control, it is often not necessary to take any form of medication. Even if you have type 2 diabetes, you can get your blood sugar and A1c levels to the normal healthy range and keep them there.

We see many cases of this with members who follow our guidelines and meal plans—they are 100% diet controlled and have maintained good numbers and good health for several years. 

Just one word of exception here: being diet controlled is not always possible for every person, so you should not feel bad if it is necessary for you to take medication. 

As my numbers continue to get better…at what point can I cut back on medication and how?

This is a good question and it’s true that if you improve your diet, you can minimize and eliminate medications over time. However, this is not something you should do on your own. 

Since your physician prescribed the medication, they are the one you need to consult with to reduce the medications.

Here’s a few tips to help you decide when to discuss medication reductions with your doctor.

If you are reducing carbohydrate intake – this will naturally reduce blood sugar levels so it will be necessary to advise your doctor you are making changes to your diet and will likely need less medication. Carbohydrate intake will influence your need for oral medications and insulin.

Consult your doctor if you are taking:

• sulfoonylureas and meglitinides – you will likely need a 50% initial reduction
• insulin – you will likely need a 30-50% initial reduction
• SGLT2 inhibitors – may cause risk of ketoacidosis in some, though this is more common when consuming <50g carbs per day.

Self-monitoring of blood glucose

The best strategy for understanding your own blood glucose patterns is to self-monitor regularly.

A structured self-monitoring routine (and keeping a log), can provide feedback on how your diet or lifestyle modifications (and medications) are influencing your numbers and what might need to change.

We recommend checking in the morning (fasting) and then doing one paired test per day (before and 2-hours after meals). You might choose lunch or dinner and alternate between meals on different days. Remember to keep a log and observe patterns. 

If you notice your post-meal (postprandial) numbers are consistently coming down, it may be time to discuss medication needs. 

If you ever start experiencing lows, it may be time to discuss medication needs. 

If you start seeing better average numbers overall, it may be time to discuss medication needs because it may be that the medications are not making too much of a difference. 

Can I prevent from going on medication?

Yes, in many cases you can, but sometimes you can’t.

As above, if you eat the right types of foods that support good blood sugar control and keep your levels within, or as close to the healthy range as possible, you can often prevent the need for any medications. Regular exercise is important, too. 

However, if you do not make lifestyle changes, chances are you will end up taking medications.

And sometimes, even when you do all the right things, you may need to take some medications, and you shouldn’t feel bad about this if it’s necessary.

Still, the more proactive you are in making diet and lifestyle changes, the greater chance you have to avoid going on medications.

Could having a proper balanced diet and exercise eradicate the use of drugs to control type 2 diabetes?

Yes in many cases it can.

We’ve seen many of our members reduce and eliminate medications such as Metformin and reduce or eliminate the need for insulin.

When you change your diet and lifestyle, you change your metabolic function and essentially you can reverse how things in the body work. Even if you take medication now, you can work toward reducing and eliminating them over time. 

As suggest above, you should consult your doctor to do this over time, never change your meds on your own. 

Diet or drugs to treat diabetes?

Diet modifications should be the first course of action to treat diabetes because it can be as effective, if not more effective than medications.

Diet modifications should also be the course of action if you are already taking medications. Diet modification can help you reduce risk of diabetes complications and optimize other health markers (like cholesterol, blood pressure and weight).

Type 2 diabetes can be diet controlled only in many cases. Making dietary modifications can help you reduce the need for medications.

Here at DMP, we will always suggest that you should work hard and be proactive in making dietary changes, because in many cases diabetes can be controlled by diet only – we’ve seen it over and over and the results are well worth it.

Dietary modification is the best form of treatment for diabetes, whether your diabetes is controlled by diet alone or in conjunction with some medication.

We also acknowledge that sometimes medication is necessary and as suggested above, you should not feel bad about this if that’s the case. 

If you are taking medications, be sure to reevaluate your meds often in consultation with your doctor. Medication needs can change and need ongoing assessment. And chances are, if you’re being proactive, your reliance on them will become less over time. 

Need help with your diet and meal planning? Consider joining us as a member.