There’s no shortage of conversations around starting a GLP-1 injection. What happens when someone stops taking one, however, gets far less attention.
A study published in BMJ Medicine examined health records from more than 333,000 US veterans with type 2 diabetes. Among those prescribed GLP-1 drugs, people who stopped treatment had a higher risk of heart attack, stroke, or death than those who continued. After two years off treatment, the risk was 22% higher.
People stop taking medication. It may be too expensive, the side effects may be difficult, or they may simply be unable to get it. So what happens after stopping matters.
The study doesn’t tell us everything we’d like to know. It was observational, so it can’t prove that stopping the drug caused the higher risk. It also did not establish what happened to participants’ glucose control after they stopped, or whether that contributed to the findings. And it did not compare medication with dietary change.
The people in this study had type 2 diabetes. For some, a GLP-1 drug may be an appropriate treatment. But that doesn’t settle the central question: were they given meaningful help to review their diet first?
“Eat better” is easy advice to give and surprisingly unhelpful advice to receive. What was the person told to eat? Has that advice helped their blood glucose? What do they actually eat on a normal day, and what could they realistically change? Those conversations take time. So does changing a habit that has been part of everyday life for years.
At The Noakes Foundation, we believe that work should come first. It should also continue when medication is needed. A prescription does not make food irrelevant, and a plan that depends entirely on an injection leaves an obvious question unanswered: what happens if (or when) the injection stops?
The study cannot tell us whether dietary changes would have altered these results. It does show why it is worth thinking beyond the next prescription. For people living with type 2 diabetes, food needs a proper place in the treatment conversation from the start.