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, an important source of energy for the body. Glucose levels are controlled by insulin, a hormone produced by the pancreas. If someone has diabetes, their body does not produce enough insulin or cannot use insulin effectively. People are mostly affected by Type 1 and Type 2 diabetes, and treatment is important for both conditions. But some diabetics choose to stop taking diabetes medication after their sugar levels return to normal. According to experts, it is not always a wise thing to do, because stopping diabetes medication has side effects.

Metformin for diabetes

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

Other remedies are-

• Sulfonylureas, which play a key role in the management of type 2 diabetes as an alternative or complement to metformin, as per research published in Diabetes Epidemiology and Management in 2021.
• 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 secretion and decrease appetite, aiding weight loss.

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

What can happen if you stop taking diabetes medication?

Some diabetes medications have side effects. Like metformin, sulfonylurea can also cause some problems. It has been associated with hypoglycemia or low blood sugar, according to a study published in StatPearls in 2023.

Whether it’s because of the side effects of diabetes medications or a preference for managing diabetes through lifestyle changes, some people choose to stop taking medications. “Scontinuing diabetes medication without medical supervision can lead to severe consequences, especially in managing blood sugar levels,” says Dr. Khamkar.

1. High blood sugar level

The most immediate effect of stopping diabetes medication is high blood sugar or hyperglycemia. If blood sugar levels rise, it can make people 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,” the expert said.

3. Diabetic ketoacidosis

For people with type 1 diabetes, stopping insulin therapy can trigger diabetic ketoacidosis, a life-threatening condition in which the body breaks down fat too quickly. It can cause accumulation of ketones, and cause 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 fluctuations can be caused by unstable glucose levels,” the expert said. In a 2022 study, people with diabetes were found to have an increased risk of depression. But users of antidiabetic drugs such as metformin and DPP-4 inhibitors have a lower risk of depression compared to those who do not use these drugs, as in a study published in Psychoneuroendocrinology.

When can diabetics stop taking their medication?

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

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

• Check with your doctor regularly to check your health progress and blood sugar levels.
• Monitor blood sugar closely to ensure levels remain stable without medication.
• Manage lifestyle factors by adopting a healthy diet, engaging in regular physical activity, and managing weight to support long-term diabetes control.
• Make gradual adjustments to avoid sudden spikes in blood sugar, and ensure that medication reduction is done step by step under a doctor’s supervision.
• Stay educated about the signs and symptoms of high or low blood sugar for quick action if needed.
• Keep follow-up appointments to ensure diabetes remains under control, even without medication.

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