Nearly 40% of type 2 diabetes patients quit medication — what can be done?

A surprising number of patients diagnosed with type 2 diabetes stop taking their prescribed medications within a year, putting their health at serious risk, according to a new study from the University of Virginia (UVA) Health System. The findings suggest that, for many patients, traditional treatment plans just aren’t sticking — and doctors need to rethink how they approach diabetes care.

Published in the Family Medicine and Community Health medical journal, the research paper argues that treatment needs to be more than simply prescribing pills. Instead, researchers advocate for a more flexible, patient-centered approach that combines medication with continuous glucose monitoring and lifestyle interventions.

One promising alternative is the Glucose Everyday Matters (GEM) program, developed by UVA researcher Daniel J. Cox, PhD, which focuses on making better food choices and adding well-timed exercise to prevent blood sugar spikes.

“Patients and significant others being personally engaged in whatever approach taken is critical,” said Cox. “Nothing works if it is not followed consistently, while most approaches will have some benefits if followed consistently for the duration of diabetes — a lifetime.”

More options for managing diabetes

Although medications like Metformin remain the standard treatment, UVA researchers emphasize the importance of newer options. Continuous glucose monitors (CGMs) — now available over the counter — give patients real-time insights into their blood sugar levels. Meanwhile, GLP-1 receptor agonists, like Ozempic, have become popular not just for managing diabetes but also for their weight-loss benefits, which can improve blood sugar control.

But medication isn’t the only way to keep diabetes in check. Cox’s GEM program offers a less restrictive alternative that helps patients learn how their eating habits and physical activity impact their blood sugar. In a previous study, two-thirds of participants who followed the GEM approach achieved diabetes remission. Cox himself has been in remission for 15 years by following the program.

Rather than focusing on strict dietary rules, GEM encourages patients to make informed food choices — swapping out sugary drinks and dried fruits for lower-glycemic alternatives, for example — and to “sit less, step more,” as Cox puts it.

Keeping patients on track

The study’s main takeaway? The best diabetes treatment is the one a patient can actually stick with. Factoring in personal preferences and lifestyle habits, health care providers can help improve long-term adherence and overall health outcomes.

To further explore the effectiveness of GEM, Cox is leading a large clinical trial funded by a $3.5 million National Institutes of Health (NIH) grant. The trial is recruiting participants who have been diagnosed with type 2 diabetes within the last two years, intending to provide more evidence for a sustainable and individualized approach to diabetes care.