Nearly 40% of patients diagnosed with type 2 diabetes jeopardize their health by discontinuing their medication within the first year, according to UVA Health diabetes experts in a recent paper that highlights an expanding range of treatment options.
The paper advocates for doctors to consider not only traditional diabetes medications but also emerging alternatives that patients may be more likely to adhere to over the long term. “Prescribing a medication or making lifestyle recommendations that a patient is not willing or able to follow for any reason is not likely to lead to improvements in diabetes outcomes,” the authors note in the paper. “The best treatment is one that is easy to implement and sustainable for the patient.”
The paper stresses the importance of collaboration between doctors and patients, rather than simply telling them what to do. By involving patients in the decision-making process and carefully listening to their preferences and lifestyle needs, doctors can increase the likelihood that patients will stick with their treatment plan. This approach ultimately helps improve blood sugar control and yields long-term health benefits, says UVA diabetes expert Daniel J. Cox, PhD, one of the paper’s authors and a member of UVA’s Center for Diabetes Technology.
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“Patients and significant others being personally engaged in whatever approach taken is critical,” said Cox, who has developed an innovative lifestyle-intervention program that is among the options described in the paper. “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.”
Options for Controlling Diabetes
In addition to traditional diabetes-management drugs such as Metformin, doctors should consider providing appropriate patients with a continuous glucose monitor, which is a sensor taped to the skin that displays changes in blood sugar on a smartphone, Cox and his collaborators suggest. The authors note that manufacturers have started to offer lower-cost, over-the-counter options available withouta prescription for patients who may face insurance barriers.
Drugs known as “GLP-1 receptor agonists” such as Ozempic have also taken off among patients with diabetes in recent years, most likely because of their weight-loss benefits, the authors write. Dropping pounds often helps better control blood sugar.
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But medicines and weight loss are not the only path to better blood-sugar control, the researchers note. Cox has developed what he calls a “less demanding” lifestyle intervention called GEM (Glucose Everyday Matters) that aims to prevent blood-sugar spikes through informed eating choices and well-timed exercise. In one study, two-thirds of participants put their diabetes into remission using the approach. Cox himself has used GEM to put his diabetes in remission for the past 15 years.
The new paper includes a detailed list of foods people using the program can reduce or replace, such as sugary drinks and dried fruits, to better control their blood sugar. But the GEM program isn’t just about giving up sweets and high-carb foods. Instead, it emphasizes understanding the effects of different foods on an individual’s blood-sugar levels, making smart eating choices, and getting extra physical activity to bring blood sugar down – to “sit less, step more,” Cox says.
“Not only does GEM help control one’s diabetes, but it is a lifestyle that promotes general health and vigor, while reducing risks of a variety of other chronic diseases,” he said.
Reference: “Current and new treatment options for adults recently diagnosed with type 2 diabetes” by Tamara K Oser, Catherine Varney, Anthony L McCall and Daniel J Cox, 17 February 2025, Family Medicine and Community Health.
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