What happens when you stop taking diabetes medication?

Diabetes is a chronic medical condition that affects the body’s ability to regulate blood sugar, or glucose, which is the body’s vital energy source. Glucose levels are controlled by insulin, a hormone produced by the pancreas. When someone has diabetes, their body does not produce enough insulin or cannot use insulin effectively. People mostly suffer from type 1 and type 2 diabetes, and medication is important for both conditions. However, some diabetics choose to stop taking diabetes medications after their sugar levels return to normal. Experts say this isn’t always wise, as stopping diabetes medication has side effects.

Metformin for diabetes

“Oral medications are usually the first line of treatment for people with diabetes, with metformin being the most commonly prescribed drug,” says internal medicine expert Dr. Kundan Khamkar. Metformin may help lower blood sugar, according to a 2023 study published in StatPearls. However, people who take it may also experience some side effects. According to a 2020 study published in the journal Obesity Medicine, nausea, vomiting, diarrhea, loss of appetite, and abdominal discomfort are common side effects of metformin therapy. Taking metformin can reduce kidney function in people with type 2 diabetes and moderate chronic kidney disease. According to a 2018 study published in Oncotarget.

Other medicines are –

• Sulfonylureas play a key role in the treatment of type 2 diabetes as an alternative or adjunct to metformin, according to a 2021 study published in the journal Diabetes Epidemiology and Management.
• Sulfonylureas, such as glipizide, help stimulate the pancreas to produce more insulin.
• Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, increase insulin production after a meal.
• Glucagon-like peptide-1 receptor agonists, such as liraglutide, increase insulin release and decrease appetite, aiding weight loss.

Insulin treatment is essential for people with type 1 diabetes because the body can no longer produce insulin. “In some cases, people with type 2 diabetes may also need insulin therapy, especially if oral medications and lifestyle changes aren’t enough,” says Dr. Khamkar.

What can happen if you stop taking diabetes medicine?

Some diabetes medications have side effects. Like metformin, sulfonylureas can cause some problems. According to a 2023 study published in StatPearls, it has been linked to hypoglycemia, or low blood sugar.

Whether due to side effects of diabetes medications or a preference to treat diabetes through lifestyle changes, some people choose to stop taking their medications. “Discontinuing diabetes medications without medical supervision can have serious consequences, especially when it comes to controlling blood sugar,” says Dr. Khamkar.

1. High blood sugar

The most immediate effect of stopping diabetes medication is high blood sugar, or hyperglycemia. When the blood sugar level rises, a person may feel very thirsty and tired.

2. Long-term problems

In type 2 diabetes, uncontrolled blood sugar increases the risk of long-term complications, including heart disease, kidney failure, and nerve damage (neuropathy). “Loss of vision, ulcers or foot infections are also common,” says the expert.

3. Diabetic ketoacidosis

In people with type 1 diabetes, stopping insulin therapy can trigger diabetic ketoacidosis, a life-threatening condition in which the body breaks down fats too quickly. This can cause ketones to build up and cause nausea and vomiting. In severe cases, it can cause coma or even death.

4. Mental health problems

Stopping diabetes medication suddenly can cause anxiety or irritability. “Due to unstable glucose levels, mood swings are possible,” says the expert. A 2022 study found that people with diabetes have an increased risk of developing depression. However, users of antidiabetic drugs such as metformin and DPP-4 inhibitors had a lower risk of depression compared to those who did not use the drugs, according to a study published in the journal Psychoneuroendocrinology.

When can diabetics stop taking medication?

Stopping diabetes medication is a decision that should always be made in consultation with your doctor. “Discontinuing insulin treatment is not an option for people with type 1 diabetes because their bodies do not produce insulin at all,” says the expert. But for some people with type 2 diabetes, medication can be reduced or stopped if their blood sugar levels are well managed with lifestyle changes such as diet and exercise.

It is important to follow these steps to safely stop taking diabetes medications:

• See your doctor regularly to check your health and blood sugar levels.
• Monitor blood sugar levels closely to keep them stable without medication.
• Address lifestyle factors by following a healthy diet, engaging in regular physical activity, and controlling body weight to support long-term diabetes control.
• Make any adjustments gradually to avoid sudden spikes in blood sugar, and make sure medications are tapered off gradually under medical supervision.
• Be aware of the signs and symptoms of high or low blood sugar so you can act quickly if needed.
• Keep follow-up appointments to keep your diabetes well under control even without medication.

You can only stop taking diabetes medicines after consulting your doctor, otherwise you may experience side effects such as high blood sugar and mental health problems. Even if diabetes goes into remission, it is important to maintain a healthy lifestyle to prevent the condition from returning. Regular monitoring of blood sugar levels and medical examination are crucial to assess whether or not medication is still necessary.