Can I control my diabetes without medication?

Some people can control and manage type 2 diabetes without medicine, but many others will need diabetes medications along with lifestyle changes. If you are newly diagnosed with type 2 diabetes, your provider may first recommend that you manage your diabetes using lifestyle changes only.

• Controlling type 2 diabetes without medication means keeping track of your blood sugar, blood pressure and cholesterol under the supervision of your diabetes care provider.
• You will also need to follow a diabetes meal plan, get to and maintain a healthy weight, and make physical activity part of your daily routine.

Keeping your A1C, blood pressure and cholesterol in check may help you avoid the long-term complications of type 2 diabetes, which is what treatment is all about. These complications include:

• Heart disease
• Stroke
• Nerve damage
• Loss of vision
• Kidney failure

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) outlines several ways you can manage and monitor diabetes:

A1C blood tests

One way to find out if you are successfully controlling your diabetes is by keeping track of your A1C blood tests. These blood tests show your average blood sugar level over the past three months. Ask your diabetes care provider what your target should be. For many people with diabetes, the goal is to keep this number below 7%. You may also be asked to check your glucose levels at home. If you can meet your blood sugar target number with lifestyle changes, you may not need medication.

Blood pressure monitoring

It’s often recommended that people with diabetes keep their blood pressure below 140/90 mmHg, but your diabetes care provider will tell you if your target is different. This may be tested through home monitoring or visits with your provider.

Diet and exercise changes

Diet and exercise should help you keep your bad cholesterol levels low and your good cholesterol levels high. A diabetes meal plan is not the same for everyone, so you should work with your diabetes nutrition care provider to find out what changes you need to make. In general, you will want to:

• Eat more fruits, vegetables, whole grains, poultry and fish
• Limit red meat to lean cuts and dairy products to low-fat
• Avoid salt
• Drink more water and avoid sugary beverages

People with type 2 diabetes should aim for 30 minutes of exercise a day or more on most days of the week.

Stop smoking

You should also stop smoking if you smoke, and drink alcohol only in moderation. Not smoking is especially important. Smoking can ruin any diabetes care plan because it narrows the blood vessels that have to stay healthy to prevent diabetes complications. Just quitting smoking will lower your risk for all the long-term complications of diabetes, including amputation of your foot or leg, which is more common in smokers with diabetes due to loss of blood supply.

Bottom line

There is no cure yet for type 2 diabetes, but according to the NIDDK, recent studies show weight loss may help you avoid diabetes medication and even put your diabetes into remission, returning your blood sugar to normal.

Type 2 diabetes remission means your blood sugar levels return to normal range for at least 3 months without any use of diabetes medication. You may be in remission if your A1C is staying below 6.5 and your fasting blood sugar level remains below 126 mg/dL. Weight loss can be achieved by a diet and exercise program or by weight loss surgery, called bariatric surgery. Remission may require weight loss of about 22 pounds that is maintained for 1 to 2 years.

The bottom line is that you may be able to manage type 2 diabetes without medication, but it will require a commitment to a healthy lifestyle change and possibly significant weight loss. Having to add a diabetes medication is not unusual. Even if you need medication to control diabetes, lifestyle changes will still be key to managing diabetes and avoiding long-term complications.