How To Get Off Diabetes Medication?

Dr Jedha, Host

Hello, and welcome back to Type 2 Diabetes Talk, Dr. Jedha here, and today we’re going to tackle a question I get asked often: How do I get off my diabetes medication?

Such a fantastic question really. If this is something you’ve been wondering about, you’re in the right place. Whether you’ve been newly diagnosed or have been managing type 2 diabetes for a while, there are proven ways to reduce or even eliminate your reliance on medications, and we’ll cover all of that in today’s episode.

If you have questions or wish to discuss this topic further, I invite you to head over to our website to engage in discussion about this. Comments are open on episode 56, so head over and leave your thoughts, challenges etc. 

01:59

In reality many people never even consider that getting off medication could be an option because let’s face it, the usual thing that happens is you go to the doctor, get a diagnosis and the next thing you’re being prescribed medications. From there, it’s often more and more meds. The opposite conversation of deprescribing medications is one that rarely gets discussed and perhaps if you’re new to the podcast you haven’t considered it for yourself. 

It is an unfortunate truth that there is an over-reliance on medication within our medical model and the treatment system for diabetes. Although nutrition, diet and lifestyle are listed as a foundation of diabetes treatment in all the medical care guidelines, the reality is many people never receive any other option because the standard medical approach is to prescribe medication. While medication can be helpful and sometimes necessary, if you need to take more and more medication, it indicates your diabetes may be getting worse, not better. Ideally, we don’t really want to see you solely relying on medications. We want you to experience the opposite, to have your diabetes health improving, with your blood sugar and A1c normalizing, through natural and sustainable means.

It’s also important to understand that the effectiveness of diabetes medications can be limited, meaning they can only influence A1c by a certain amount. For those newly diagnosed who may be listening, A1c is a blood test done by your doctor that measures the average glucose or sugar on your blood over a 3 month period. It’s used to diagnose diabetes and to assess your diabetes control. Diabetes medications can only exert a certain lowering effect on A1c. For instance, Metformin can reduce A1c by up to 1.5%, while SGLT2 inhibitors might lower it by only 0.7%. This often leads to the use of multiple medications simultaneously, a practice known as polypharmacy, which can result in a host of side effects and complications, especially over time. So again, ideally we don’t really want to see you solely relying on medications. 

First, let’s be clear about one thing: medications can be an important part of managing type 2 diabetes, especially when blood sugar levels are dangerously high. Medications like Metformin, Sulfonylureas, DPP-4 inhibitors, and SGLT2 inhibitors, insulin, and others help lower your blood sugar levels, and they can be life-saving when your body needs that support. However, medications are often seen as a long-term solution, which isn’t always the case. What many people don’t know is that nutrition, diet and lifestyle changes can have such a profound impact on your health that they can reduce or even eliminate the need for medications altogether.

05:28

Yes, deprescribing medications, or the process of reducing or stopping medications, is possible. And it is a topic that deserves a lot more attention and education to inform people of the possibility, as we know many people hate taking medications. 

So can you get off diabetes medication? For many people, most people in fact, you will be able to reduce medication and many will be able to stop medications too. On the opposite side of the equation we’ve got those of you who may not be on medication and want to avoid it, well, the information in this podcast is equally as important to you too. 

What the evidence actually show us is that deprescribing medications, getting people off medications or at the very least reducing the number of medications or the dosages, is not only possible but beneficial. Why would that be? 

One primary reason is side effects. Long-term use of medications like Metformin can lead to vitamin B12 deficiency, while others like insulin and Sulfonylureas and insulin increase the risk of hypoglycemia, which can be a major issue the older you get. Studies show a whole range of minor side effects related to diabetes medications that aren’t so minor if you’re experiencing them – blurred vision, lightheadedness and weakness are very common side effects of diabetes meds that could be overlooked but could seriously affect your life, leading to falls and hospitalizations. These are all documented in research findings. 

Polypharmacy is another reason. Polypharmacy is a fancy word for taking multiple medications, which is common in people 60 and over, but it is not good for anyone, due to the potential side effects and drug-to-drug interactions. 

Quality of life is another very important reason. Reducing medication can decrease the burden of managing multiple drugs and their associated side effects, leading to an improved quality of life.

The evidence suggests there is an overwhelming benefit of reducing medications in diabetes, and we know this is highly possible so it’s something we should all be encouraging and supporting. Importantly though, you do need to work with your doctor to reduce and stop medications. And we’ll be covering more about this as we move through this episode. 

08:13

So you might be thinking, when is it a good time to consider getting off medications?  

Studies have shown that for those with stable and low A1c levels (7% or below), deprescribing medication does not significantly affect blood glucose control, in most cases. In other words, if your A1c levels are stable at 7% or below, it’s time to consider talking to your doctor about reducing the medications, as the research shows that in many cases it makes no difference to A1c levels to describe,no difference, A1c levels stay stable. It’s even better if you can achieve levels below 6.5% or better yet, levels below 6%, because once your levels are in the normal range, or close to, doctors are usually happy to support reduced medication.

So you may be thinking, what’s the secret to getting off diabetes medications? 

Well, the key lies in addressing the root cause of the problem, which is high blood sugar levels and high circulating insulin levels that both promote insulin resistance. 

And how do we do that? It largely comes down to nutrition and diet – these are your most powerful allies, and your overall lifestyle can be an influence too. 

10:27

So, let’s get down to the how. What steps do you need to take if you want to reduce or stop your diabetes medication? Well, it’s crucial to do so under medical supervision, so the first step to take is to never attempt to do it alone, without advising your doctor. It’s always important to discuss your desire to reduce or stop medications with your medical doctor, GP, physician. Now, that conversation might not happen right away, as you might first want to work toward achieving a stable A1c level first, as they are going to take you more seriously if your levels are stable below 7% or below 6% is even better as we emphasized before. 

That said, certainly, if your doctor is suggesting you should go on medication or take more medication and you’d prefer not to, you should be assertive and discuss your goals and desires with your doctor. If they try to object, you can suggest that they please give you 3-4 months to turn things around on your own before having the medication discussion again, which will give you time to focus on getting proactive so you can get your A1c down naturally. Once you return to your next appointment, your conversation with the doctor is going to look a whole lot different. 

And that’s the key. In order to reduce or get off diabetes medications, you need to get your A1c levels down into a healthy range, below 7% and ideally below 6%. 

How do you do that? Diet and nutrition is your primary treatment strategy: Focus on eating to treat your diabetes, the details of which we covered extensively in episode 6. What you eat has the most powerful impact on your blood sugar levels and your overall metabolism and health. Food is the fuel that feeds all our cells, so quality nutrition is key to treating your diabetes naturally. If you get proactive with your nutrition plan, you can bring your A1c down by 3 or 4% in 3-4 months. We’ve seen this happen a lot when people take my clinically proven T2Diet Program – having an A1c reduction from 10% down to 6 or 7% is possible in the 16 week program. If your levels aren’t as high as 10 when starting, then achieving 6 or 7% in around four months is possible. If you have prediabetes, most people achieve normal A1c levels below 5.7% within 16 weeks taking our Prediabetes Reset Program, we’re seeing that happen all the time. Our nutrition programs and memberships really help remove any confusions about what to do and provide all the tools, resources and support to help you achieve lower blood sugar and A1c so you can reduce and stop the meds, so please head to our website at Type2DiabetesTalk.com/programs to see the options we have available. I’d love to see you join us. 

So here’s the thing, the overall quality of your nutrition plan is important, but of course the key macronutrient that influences blood sugar is carbohydrates. By reducing the amount of sugar and carbohydrates you eat, you help reduce blood sugar spikes and lower the amount of insulin your body needs to produce. This can lead to more stable blood sugar and A1c levels, and over time, reduce your need for medications. In episode 22, we covered 3 simple steps to lower carbs and focus on the right types to lower A1c, so go and listen to that episode for key steps to take. Essentially, you just need to get proactive and put the right nutrition strategies in place, and you will see your A1c levels come down and stabilize so you can then have the discussion with your doctor to reduce or stop medications. Of course, that sounds simple enough but it isn’t always easy to do, especially without support, which is where our programs and memberships can really help, so again, please do head down to the website and take one of our programs or join us as a member, it will honestly be the best thing you ever do – okay, yes I may be a bit biased, but honestly, I’m hearing about our members success all the time and I genuinely know our programs work, they’ve even been clinically proven by the highest standard of evidence – a randomized controlled trial, which is why I want you to know about them – we’re here to support you if you need it.

The other thing I want to mention is, if you are using a blood glucose monitor, focus on your postprandial blood sugar levels. You need to be keeping these levels under 140 mg/dl, or 7.8 mmol/l 2-hours after meals, as this will help you lower your A1c levels into the healthy range. Listen to more on healthy blood sugar ranges and why your postprandial, after meal levels are so important in episode 11.

Regular physical activity is the second major component to this puzzle of getting off meds. Exercise improves your body’s sensitivity to insulin, meaning your cells are better able to use the glucose in your blood, which helps lower your blood sugar naturally. So add in a little more activity to your daily routine. Whatever it is, walking, swimming, gardening, resistance training, it’s all going to help improve insulin sensitivity which is very important to over blood sugar control. 

Incorporating mindfulness practices, managing stress, and improving sleep quality can complement nutrition changes and physical activity or a more holistic approach to stabilizing blood sugar and A1c levels. 

17:23

When it comes to getting off the diabetes medications, there are different methods, including complete withdrawal and discontinuation of all medication – this doesn’t tend to happen as much in general practice, due to the conservativeness of doctors; reducing dosage over time is more common and if you’re on multiple medications, stopping one medication and then another is usually what happens. As you and your body demonstrate that you can maintain stable A1c levels with each medication reduction, your doctor will eventually stop all medications. So the most common track is reduction of doses, then stopping one medication at a time. Or if you’re only taking one medication it will be a reduction of dosage until cessation of the medication. If all you’re taking is Metformin, you may be able to come off it sooner by replacing it with a natural therapeutic like Berberine, which we discussed in episode 21. 

One of the most important factors in all of this is your mindset and commitment to you. The journey to reduce or eliminate medications is possible, but it requires proactive management and a shift in mindset. You need to be consistent in making healthier choices, not perfect, as consistency is more important than perfection. And, you need to understand and accept that progress takes time. There is no quick-fix 3-day pill to achieve the goal of getting off medications. Yes, it can happen, knowing that it can happen and holding that hope are powerful motivators in committing to you. But getting off medication usually doesn’t happen overnight, so it’s important to have patience as well. Take small proactive steps with your nutrition and lifestyle and keep taking them. There’s a saying I enjoy and that’s: healthy isn’t a goal it’s a way of life. FOCUS on the right things until you get there. Keep being proactive with your nutrition and lifestyle, as small steps really do add up to big changes over time. 

If your goal is to get off medications, you can do it and we’ve covered the key things that will help you achieve that goal, right here in this episode. You can also head back to listen to other key episodes mentioned: Episode 6 on how to eat to treat diabetes, Episode 11 on healthy blood sugar levels and why after meal levels are important to lowering A1c, Episode 21 about Berberine – a natural therapeutic as effective as Metformin, Episode 22 on 3 simple steps to lower A1c levels. We also did a fantastic Medication Series in episodes 15, 16, 17 and 18, and I’d highly recommend you go back and listen to those episodes for lots of valuable insights and information. And please do consider joining one of our nutrition programs, or joining us as a member, as our programs and services really help remove any confusions about what to do and provide all the tools, resources and support to help you achieve lower blood sugar and A1c so you can reach your goal to reduce and stop the meds.

Of course, if you’re already one of our members, head to the members library for a more detailed roadmap on reducing your medications and a letter you can provide to your doctor. And be sure to use the monthly member check-ins to share any challenges you’re facing so we can help you with those, and share your progress as well of course, as we love hearing about that too. 

Thanks for tuning in and if you feel this information would help others, please share, I’m sure they will thank you for offering them hope of another pathway that doesn’t solely rely on medications to manage their diabetes.

That’s all for today. 

Dr Jedha, over and out.