Diet and exercise only?

Anyone else controlling their diabetes with only diet and exercise, no drugs? Could you post your story? Here is mine: In Sept 2015, I went in for blood work. My blood glucose was 195, so my doctor told me to schedule an A1c. It came back as 9.2. Before I received my results, my sister in law, who manages a pharmacy showed up with a prescription for me. It was for Metformin, I refused to take it, until I received my results, which I got the next day. I called the office to talk to the doctor, had to explain the situation to the receptionist, (not even his MA), and got a call back from the receptionist saying I could try diet and exercise and come back in 3 months. My sister in law said I should have him prescribe a monitor, so I called back, and once again got to explain it to a receptionist, the monitor was also called in to the pharmacy without my knowledge. After about a month of anger, fear and struggle, I made an appointment with the doctor and told him all this. He admitted he had “dropped the ball”. I am trying to find a better Doctor, but in our rural area it is hard. In 3 months my A1 c dropped to 5.5.


I was diagnosed in 2009 fasting 325, A1c of 12.0. I did start on metformin plus my doctor gave me a prescription for a fantastic diabetes education course, 20’hours of classes and private consultations! (Classes like this dont exist much anymore)
So I increased my exercise and started Low carb WOE. I balance my carb intake to match my bodies ability to process them.
A1c at 4 months 7.4 at 7 months 6.3. Started to reduce the metformin, elimnated year two. Now 7 years my A1 5.6. No diabetes medications.
At 70 years old now I run three miles every other day, try to fit in at least a 5 or 10 k activity once a month. Sold my car, so walk most places. I am still a confirmed low carber.
I believe I am fortunate to be able to produce insulin, and I have never had an issue with liver dumps. I have not lost any weight, gained muscle and lost fat though. )

There are many of us out there who are fortunate to be able to manage T2 on diet and exercise only or even more that take only metformin. Welcome to the club!


I was diagnosed with an HBa1c of 8.7 and trashed the metformin prescription my doctor gave me after reading about possible side effects. After some research I ended up with a management plan that worked. Just don’t underestimate the amount of time and effort you will need to put into a successful diet and exercise program for managing diabetes. Or the amount of constant monitoring you will need to do in order to ensure your program is working.
I did manage to control my diabetes type 2 successfully with diet and exercise for 16 years, with Hba1c levels all below 6.0, until I got sidetracked by a cardiac arrest that resulted in reduced mobility for a couple of years.
While I was managing during those first 16 years the rules were:

  • a brisk 40 minute walk following each of my three daily meals
  • limiting carbs to ones that are low on the GI scale, like barley, squash, zucchinis, and certain types of rice.
    I did not at the time even consider a LCHF plan as I needed the quick energy release from real carbs to get through my walking regime. However, the low GI diet worked very well.

@Pat_Ann it could be that you were advised to “try diet and exercise” as that is the suggested protocol to initially follow by the American Association of Clinical Endocrinologists. You might find the link which details the 2016 algorithm of interest.

All the very best to you!

The AACE protocol for a patient appearing with an A1c of 9.2% is not to “try diet and exercise.”

While the AACE algorithm does recommend that you use diet and exercise as first and primary therapy for diabetes it is much more aggressive about normalizing blood sugars. If you appear at your doctors door with an A1c > 9% and any “symptoms” the AACE recommends you start off with insulin to at least normalize your blood sugar. And if you don’t have symptoms you should start with double or triple therapy. That doesn’t mean you have to stay on insulin (or meds), but if your A1c has reached over 9% your average blood sugars are over 200 mg/dl and your poor pancreas is likely just pooped out. The fact that you were successful on your own is just a credit to your devotion and discipline.

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@Pat_Ann I must say I was negligent in using your quote alongside the AACE algorithm. @Brian_BSC has highlighted my error in his recent post. My purpose in posting the algorithm is simply to help. I hope it was helpful. That is my only motive.

I wish you all the best as you find what works for you in managing your diabetes.

@jojeegirl, this change to early insulin us is very new and I think the vast majority of doctors have real hesitancy to employ insulin with newly diagnosed patients. I think we both agree on the importance of diet and exercise.

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Thanks for sharing. So wonderful to know I am not alone. Especially the suicidal thoughts, I looked up “painless ways to kill yourself”. Yes, I am a chicken. But I am trying to come to grips with diabetes. I do low carb, don’t count them, just read the nutrition info on the back of packages. Test multiple times when I try new food, otherwise no, my doctor gave me no instructions, so I wing it. My husband told me (when I was having a depressed rant), that I was lucky it wasn’t cancer, only diabetes. He is lucky he is still alive… Now he is very supportive, and grills a lot, and he cooked my morel mushrooms this weekend in almond flour. He has even started looking at the carb count on the back of packages when we shop.Again, thanks for sharing, and can we have more stories! They make me feel less isolated and alone.


I was never advised anything. The lack of communication was horrible.

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I had no idea about this. It was never mentioned to me either. Probably best I didn’t know this, as I would probably be on meds and eating the high carb diet recommended by the ADA, instead of starting my own research and reading about low carb, and following that lifestyle.

I think it’s important for you to understand that, although you do not currently require medication and are successfully managing your D through diet and exercise alone, you still have diabetes. (Disclaimer: I am not meaning to say that you are claiming that you have “cured” your diabetes through diet and exercise alone. The point I’m trying to make is that if you were to resume your pre-diagnosis “lifestyle”, your BGs would, in a matter of time, revert back to their diabetic levels, as you are probably already aware.) Who knows, you may never require medication to keep your BG within normal limits if you continue the diet and exercise regimen that lowered your A1c so impressively. But I’d just hate to see you view yourself as a failure if your diabetes progresses to the point where, despite a zero-carb diet and a fanatical amount of daily exercise, you require medication. That would not be your fault. I only want to avoid as much blame as possible, because I most definitely do NOT believe that people with Type 2 caused it themselves.


But is not helpful to post the AACE algorithm in response to an OP who originally presented to a physician with a significantly elevated A1c of 9.2. For the OP, this algorithm is about as helpful as her PCP allowing her to “fall through the cracks” with an A1c that high. If your intent was not to offer unsound medical advice, then you should have indicated that the link you posted was not meant for those whose BGs and/or A1c’s are quite high. Like Brian, I believe in the utility of a lower-carb diet and a healthy exercise regimen, but this should not be recommended in cases where treatment of significantly elevated BGs/A1c levels with medication should occur first and foremost.


well done, I know how much work went into that

I am not no carb, Nor am I a fanatic about exercising. I walk twice a day for a bout 3 miles total.

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@rgcainmd Thank you.

I didn’t mean to imply that you ate no carbs, nor that you exercised fanatically. I believe it is possible for some people, such as yourself, to eat a lower-carb diet and increase your exercise, with good results (a much lower A1c). And I congratulate you for your self-discipline and diligence (because I doubt I could do what you did!)

I am not sure what all the back and forth is. I think we have forgotten about a person with T2 who has taken control of her life. I thinks that is great. Unless she is doing harm to herself, it does not matter what current protocol is.
(Please read my post above) ( note my AIC was 12.0) I was very fortunate to have a doctor who explained all the treatment options ( including insulin)
But summed it up by saying doctors read reports and prescribe medication. That’s all. She felt that the key to managing T2 was understanding the changes I needed to make. And why it was critical. . The best part she connected me wth a diabetes educator (nurse) who was a t2. What a great serious of discussions. Yes there where some limits I had to start metformin
The most important concept is that they gave me the power and knowledge to control my T2.

This is not an answer for everyone, nor even an answer for anyone else.
But each day I make all the best decisions and enjoy my life.

I still get grief from the medical field. I just tell them to away and leave me alone.
If I have issues I will call them. Other than that I have blood work done every six months.



@Fraser70 That is what is all about DSME diabetes self management education! Find out what works for you, collaborate with your DSME team BE YOUR OWN ADVOCATE, and most of all BE HEALTHY!! 8))

I agree except
The best information and encouragement does not come for the medical community, but from others who are dealing with diabetes.
Real information from real people )