What happens when diabetes medication is stopped?

Diabetes is a chronic disease that affects the body’s ability to regulate blood sugar or glucose, an essential energy source for the body. Glucose levels are controlled by insulin, a hormone produced by the pancreas. If someone has diabetes, either their body doesn’t produce enough insulin or they can’t use insulin effectively. People often suffer from both type 1 and type 2 diabetes, and medication is important for both conditions. But some diabetics decide to stop taking diabetes medications once their sugar levels return to normal. Experts say, stopping diabetes medication is not always wise as it has side effects.

Metformin for diabetes

Internist Dr. Kundan Khamkar says, “Oral medications are usually the first line of treatment for people with diabetes, and metformin is the most commonly prescribed. Metformin helps lower blood sugar levels, according to research published in StatPearls in 2023. But people who take it may also experience some side effects. According to research published in Obesity Medicine in 2020, nausea, vomiting, diarrhea, loss of appetite, and abdominal discomfort are common side effects experienced with metformin therapy. According to a 2018 study published in Oncotarget.

Other medicines are –

• Sulfonylureas play a key role in the management of type 2 diabetes as an alternative or adjunct to metformin, according to research published in Diabetes Epidemiology and Management in 2021.
• Sulfonylureas, such as glipizide, stimulate the pancreas to produce more insulin.
• Dipeptidyl peptidase-4 (DPP-4) inhibitors, such as sitagliptin, increase postprandial insulin production.
• Glucagon-like peptide-1 receptor agonists, such as liraglutide, improve insulin release and reduce appetite, helping with weight loss.

Insulin therapy 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 need insulin therapy, especially when oral medications and lifestyle changes aren’t enough,” says Dr. Khamkar.

What happens if you stop taking your diabetes medication?

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

Whether it’s because of side effects of diabetes medications or a desire to control diabetes through lifestyle changes, some people decide to stop taking medications. “Discontinuing diabetes medications without medical supervision can lead to dire consequences, especially when it comes to controlling blood sugar,” says Dr. Khamkar.

1. High blood sugar level

An immediate effect of stopping diabetes medication is high blood sugar levels or hyperglycemia. If the blood sugar level rises, it makes a person 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 neuropathy (neuropathy). “Loss of vision, ulcers or foot infections are also common,” says the expert.

3. Diabetic ketoacidosis

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

4. Mental health problems

Stopping diabetes medication suddenly can cause anxiety or irritability. “Mood swings are possible due to unstable glucose levels,” says the expert. In a 2022 study, people with diabetes were found to be at higher risk of depression. But according to the study published in Psychoneuroendocrinology, users of anti-diabetic drugs such as metformin and DPP-4 inhibitors had a lower risk of depression compared to those who did not use these drugs.

When can diabetics stop taking medication?

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

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

• See 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 eating a healthy diet, getting 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 gradual drug reductions are made under a doctor’s supervision.
• Be aware of the signs and symptoms of high or low blood sugar so you can act quickly if necessary.
• Keep follow-up appointments to ensure diabetes is well controlled even without medication.

You can stop taking diabetes medicines only after consulting a doctor, otherwise you may experience side effects like high blood sugar levels and mental health problems. Even if diabetes goes into remission, it is essential to maintain a healthy lifestyle to prevent the condition from recurring. Regular monitoring of blood sugar levels and medical check-ups are very important to assess whether medication is still needed or not.