Some drugs are addictive and can cause withdrawal symptoms when you stop taking them. Many of us know how challenging it is to stop smoking, to give up alcohol, or to forego illegal drugs like methamphetamine, cocaine, and heroin. By increasing the level of dopamine in our brains, these substances create a need that only they can meet.
If you have Type 1 diabetes, you will always need to take insulin. And if you are taking some legal drugs, including aspirin and the statins, you shouldn’t stop taking them suddenly. Doing so can triple your risk of heart disease.
But if you have Type 2 diabetes, you can stop taking any of the diabetes drugs when you are able to manage your blood glucose without them. These drugs are not addictive.
However, judging from the number of questions that people with diabetes keep asking me, many people with Type 2 diabetes worry that, once they start injecting insulin or taking oral drugs like metformin, they will be hooked for life. Some people think that when their doctors tell them that it’s time that they take insulin, it’s a sign that they have failed.
You must manage your glucose firstNothing could be further from the truth. In fact, when you are diagnosed with Type 2 diabetes is when you** must** take one or more of the diabetes drugs to bring your blood glucose levels down to normal as quickly as you safely can.
The speed in which you manage your blood glucose is crucial. Every day that your glucose is above normal, you increase your risks of complications. Two large studies, the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study, established this fact.
Generally, our doctors will prescribe metformin to people with Type 2 diabetes first. This is the most common diabetes drug because it works, has one of the best safety profiles, and is inexpensive.
Insulin works fastest
Taking insulin works fastest, but many people think that taking it is a sign that they have failed. Insulin has usually been the last resort for people who have Type 2 diabetes. “If you don’t shape up, I’m going to make you inject insulin,” is a threat you may hear from your doctor.
Now, however, some doctors and clinics are turning the timeline around by starting their diabetes patients with insulin. The result has been a powerful effect in a short time.
Two leading diabetes experts emphasize focusing on the goal of getting your blood glucose level down to normal. Your diabetes isn’t worse if you have to take pills or insulin, writes Richard Jackson, M.D., with Amy Tenderich in “Know Your Numbers, Outlive Your Diabetes.” “You need to keep your eye on your A1C result, not on the treatment needed to achieve it.
I told William Polonsky, Ph.D., about the fear some people have of being hooked on diabetes drugs, when I interviewed him in June 2016 for my article “Why People with Diabetes Aren’t Managing It Better.” He seemed surprised at my statement.
Get to a safe place
“I actually make the opposite argument that your goal is to get to a safe place with your A1C,” he replied. “Your long-term goal may be great, but whatever you can do now, do it because there’s a fire burning when you are in an unsafe place. You need to do something about that.”
Only after you bring your A1C level down to normal, do you have the luxury of managing our diabetes without drugs. But the key ways to do this — getting down to a normal weight, eating fewer carbohydrates, and becoming more active — all take a lot more time. As much as I wanted to manage my own diabetes without drugs, it took me 13 or 14 years to do that.
You need to be clear what your goals are for both the short- and long-term. You have to remember that the only thing that you can accomplish now is the next right thing for your health.
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David Mendosa was a journalist who learned in 1994 that he had type 2 diabetes, which he wrote about exclusively. He died in May 2017 after a short illness unrelated to diabetes. He wrote thousands of diabetes articles, two books about it, created one of the first diabetes websites, and published a monthly newsletter, “Diabetes Update.” His very low-carbohydrate diet, A1C level of 5.3, and BMI of 19.8 kept his diabetes in remission without any drugs until his death.