Deprescribing for Type 2 Diabetes

If you have type 2 diabetes, you may wonder whether improving your blood sugar or losing weight could allow you to take less medication. In some cases, the answer may be yes, but reducing medication isn’t simply a matter of stopping a prescription. 

“Deprescribing” is a planned process supervised by a healthcare professional. The goal isn’t to eliminate medication at all costs. It’s to make sure each medication is safe, beneficial and appropriate. 

Some people may reduce or discontinue certain medications as their metabolic health improves, while others continue to need medication for blood sugar control or additional heart and kidney benefits. 

When Susan joined Virta, she was taking metformin and had an A1C of 10.0%. As her blood sugar and metabolic health improved on Virta, her care team helped her reduce her daily metformin dose by 1,000 mg while coordinating the change with her primary care provider. Her experience shows what safe deprescribing can look like: not simply stopping medication, but adjusting treatment as a person’s health changes. 

Note: Never stop insulin or another diabetes medication without medical guidance. 

What is Deprescribing for Type 2 Diabetes?

 Deprescribing is the clinician-guided process of lowering a dose, discontinuing a medication or replacing it when the risks or burdens outweigh its benefits or when the medication is no longer needed. The deprescribing process may involve one medication or a gradual series of changes. It should also include monitoring of blood sugar, symptoms and other relevant health markers. 

Deprescribing is not: 

• Abruptly stopping medication without medical supervision.
• A guarantee that someone will become medication-free.
• Evidence that the original prescription was unnecessary or inappropriate. 

Why Might Someone with Type 2 Diabetes Need Fewer Medications? 

 Someone with type 2 diabetes may need fewer medications for several reasons:

 Improved insulin sensitivity and lower glucose levels may change how much medication a person needs.

• Meaningful, sustained weight loss can improve metabolic health and contribute to reversal.
• Nutrition changes, increased activity, metabolic surgery or other treatments may also change medication requirements.
• Medication may need to be reduced sooner when a treatment plan rapidly lowers glucose and creates a risk of hypoglycemia (low blood sugar).

 Decisions about deprescribing also depend on: 

• Glucose readings
• A1C
• Diabetes duration
• Other medical conditions
• The purpose each medication serves 

What Are the Potential Benefits of Deprescribing?  

There are several potential benefits of deprescribing: 

• Lower risk of hypoglycemia
• Fewer medication side effects
• Less treatment complexity and daily burden
• Potentially lower medication costs
•  A regimen that better reflects your current health 

What Does Deprescribing for Type 2 Diabetes Look Like? 

The deprescribing process can vary by individual, but generally, the process can look like: 

• A review of the full medication list. The healthcare provider considers current glucose levels, A1C, kidney and liver health, side effects, hypoglycemia, treatment burden and the reason each medication was prescribed.
• Identifying the safest medication to adjust first. Priority may be given to treatments that pose the greatest immediate risk of low blood sugar.
• Reducing or discontinuing medication according to a clinical plan. Some medications can be stopped, while others may require dose adjustments or closer follow-up.
• Monitoring the response. Glucose readings, symptoms and lab results can help determine whether additional changes are appropriate.
• Reassessing over time. Medication may need to be restarted or adjusted if blood sugar increases over time. 

Is It Safe to Stop Diabetes Medications? 

It can be safe to reduce or stop certain diabetes medications, but only when a qualified clinician determines that it’s appropriate and provides a monitoring plan. You should never stop taking prescribed medications without the OK from your healthcare provider.

What Happens If You Stop Taking Type 2 Diabetes Medication?

The outcome depends on the medication, current metabolic health and whether other treatments are controlling glucose. Some people maintain healthy blood sugar levels, while others experience rising blood sugar levels. 

How Virta Approaches Deprescribing 

Virta combines individualized nutrition therapy, remote monitoring, health coaching and clinician-led medication management. As glucose levels improve, clinicians can adjust medications proactively rather than waiting for low blood sugar or other complications. 

The goal is to improve metabolic health by treating the root cause while using medications when they remain beneficial. 

For some people, sustained improvements in metabolic health may change the need for GLP-1 therapy, a decision to discontinue a GLP-1 should be made with  clinician guidance. 

Deprescribing FAQs

What is deprescribing in diabetes?

Deprescribing is the clinician-guided process of reducing or stopping diabetes medications that are no longer needed or beneficial. Treatment changes should always be made under medical supervision and monitoring.

Can you manage type 2 diabetes without insulin?

Some people may be able to reduce or stop insulin as their blood sugar and metabolic health improve. Whether this is possible depends on the individual. Insulin should never be changed without a healthcare provider’s guidance.

Can you stop taking diabetes medication if your blood sugar improves?

Possibly, but improved blood sugar may also mean the medication is working. A clinician should review your glucose trends, A1C and overall health before making changes.

Is diabetes reversal the same as deprescribing?

No. Deprescribing means reducing or stopping medication, while reversal means maintaining an A1C level below 6.5% for at least three months without glucose-lowering medication.

What medications are most commonly deprescribed in type 2 diabetes?

Clinicians may first consider medications that can cause hypoglycemia (low blood sugar), such as insulin or sulfonylureas. This decision depends on each medication’s risks, benefits and role in protecting heart or kidney health.

Can weight loss reduce the need for diabetes medications?

Yes. Weight loss can improve insulin sensitivity and blood sugar control, which may reduce medication needs for some people. Medication changes should still be made under medical supervision. 

The Takeaway

Your medication needs may change as your metabolic health changes. But remember: deprescribing should be treated as a clinical process, not a do-it-yourself goal. Talk to your healthcare provider to see if deprescribing is an option for you.

If you are diagnosed with type 2 diabetes or another metabolic condition and want to live a healthier lifestyle, Virta Health may be able to help. By making healthy lifestyle changes in a medical setting with supportive resources like 1:1 virtual coaching, you can regain control of your health and feel like yourself again. See if you’re eligible for Virta Health here.