I’m always a fan of avoidance of medication IF you can get away with it. The first thing that needs to be determined is the A1c percentage because that determines how well or not well your diabetes is controlled at this time. If the number is substantially higher (greater than 6-6.5%) medication may be in order at least in the short term. If it’s in the upper 5% range say, something like 5.8%, most of the time you can get away with dietary modification and weight loss if it is necessary. The most important factor when dealing with diabetes is avoidance of complications, like cardiovascular and cerebrovascular disease, avoidance of peripheral artery disease, avoidance of smoking, and complications, directly of diabetes, including kidney disease and retinal disease. If your diabetes is not well controlled (high A1c value), and you elect to just do dietary modification, that can be a recipe for disaster, (if your blood sugar is rapidly elevated, you can have a condition called hyperosmolar, nonketotic syndrome with associated severe dehydration and remarkably elevated blood glucose, as well as diabetic ketoacidosis, and these require hospitalization) so it really depends on how well the diabetes is controlled at this time. If you’re somewhat to remarkably overweight, then, lowering your body weight will definitely help if not eliminate the need for medication, but everybody is a little bit different physiologically. One of the other issues I have seen with diabetic patients is elevation of triglycerides as well as cholesterol. This would need to be managed appropriately as well, depending on the values obtained.
