What happens when you stop diabetes medication?

Diabetes is a chronic medical condition that affects the body’s ability to regulate blood sugar or glucose, a vital energy source for the body. The levels of glucose are controlled by insulin, which is a hormone produced by the pancreas. If someone has diabetes, either their body will not produce enough insulin or it won’t be able to use insulin effectively. People are mostly affected by Type 1 and Type 2 diabetes, and medications are important for both the conditions. But some diabetics choose to stop taking diabetes medicines after their sugar levels return to normal. According to experts, it is not always a wise thing to do, as stopping diabetes medications has side effects.

Metformin for diabetes

“Oral medications are typically the first line of treatment for people with diabetes, with metformin being the most commonly prescribed one,” says internal medicine expert Dr Kundan Khamkar. Metformin can help in lowering blood sugar, according to research published in StatPearls in 2023. But people taking it may also have some side effects. Nausea, vomiting, diarrhea, loss of appetite, and abdominal discomfort are common side effects experienced during metformin therapy, as per research published in Obesity Medicine in 2020. Taking metformin may reduce kidney function in people with type 2 diabetes and moderate chronic kidney disease, as per a 2018 research published in Oncotarget.

Other medications are –

• Sulfonylureas, which plays a key role in the management of type 2 diabetes as an alternative or a complement to metformin, as per research published in Diabetes Epidemiology and Management in 2021.
• Sulfonylureas, like glipizide, help stimulate the pancreas to produce more insulin.
• Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, increase insulin production after meals.
• Glucagon-like peptide-1 receptor agonists, like liraglutide, enhance insulin release and reduce appetite, aiding in weight loss.

Insulin therapy is essential for people with type 1 diabetes since the body can no longer produce insulin. “In some cases, people with type 2 diabetes may also require insulin therapy, especially when oral medications and lifestyle changes are not sufficient,” says Dr Khamkar.

What can happen if you stop taking diabetes medication?

Some of the diabetes medications have side effects. Like metformin, sulfonylureas can also lead to some problems. It has been associated with hypoglycemia or low blood sugar, according to research published in StatPearls in 2023.

Whether it is due to side effects of diabetes medications or a preference to manage diabetes through lifestyle changes, some people choose to stop taking the medications. “Discontinuing diabetes medication without medical supervision can lead to severe consequences, particularly in managing blood sugar levels,” says Dr Khamkar.

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1. High blood sugar level

The most immediate effect of stopping diabetes medications is high blood sugar level or hyperglycemia. If the blood sugar level shoots up, it can make a person 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). “Vision loss, ulcers or foot infections are also common,” says the expert.

3. Diabetic ketoacidosis

For people with type 1 diabetes, stopping insulin therapy can trigger diabetic ketoacidosis, a life-threatening condition where the body breaks down fat too rapidly. It can lead to an accumulation of ketones, and cause nausea as well as vomiting. In severe cases, it may lead to coma or even death.

4. Mental health issues

Suddenly stopping diabetes medications can lead to anxiety or irritability. “The mood fluctuations are possible due to unstable glucose levels,” says the expert. During a 2022 study, people with diabetes were found to have an increased risk of depression. But users of antidiabetic drugs like metformin and DPP-4 inhibitors had lower risk of depression compared to those who didn’t use these medications, as per the study published in Psychoneuroendocrinology.

When can diabetics stop taking their medications?

Stopping diabetes medication is a decision that must always be made in consultation with a doctor. “Stopping insulin therapy is not an option for those with type 1 diabetes, as their body does not produce insulin at all,” says the expert. However, for some people with type 2 diabetes, medication can be reduced or stopped if their blood sugar levels are well-managed through lifestyle changes like diet and exercise.

To stop taking diabetes medication safely, it is important to follow these steps:

• Check with a doctor regularly to check your health progress and blood sugar levels.
• Monitor blood sugar closely to ensure levels remain stable without medication.
• Address lifestyle factors by adopting a healthy diet, engaging in regular physical activity, and managing weight to support long-term diabetes control.
• Make any adjustments gradually to avoid sudden spikes in blood sugar, and ensure that reductions in medication are made step by step under a doctor’s supervision.
• Stay educated about the signs and symptoms of high or low blood sugar to act quickly if needed.
• Maintain follow-up appointments to ensure diabetes remains well-controlled, even without medication.

You can stop taking diabetes medication only after consulting with a doctor otherwise you will experience side effects like high blood sugar level and mental health issues. Even if diabetes goes into remission, it is essential to maintain healthy lifestyle changes to prevent the condition from returning. Regular monitoring of blood sugar levels and medical check-ups are crucial to assess whether medication is still necessary or not.