New study demonstrates feasibility and safety of deprescribing diabetes medications when lifestyle medicine is integrated into primary care

In routine primary care settings—not specialty clinics or intensive lifestyle programs—lifestyle medicine was associated with a meaningful reduction in diabetes medication use in a subset of patients.

ST. LOUIS, March 31, 2026 /PRNewswire/ -- A new research study from the American College of Lifestyle Medicine provides real-world evidence that deprescribing glucose‑lowering medications is both feasible and safe when patients with type 2 diabetes receive lifestyle‑informed care in primary care settings.

The retrospective chart review, published in the Journal of Clinical Medicine, examined electronic health records from 650 adults with type 2 diabetes receiving care at two primary care practices that integrate lifestyle medicine principles into routine visits. Using a structured deprescribing framework, researchers identified 41 confirmed cases—approximately 6.3% of patients—in which diabetes medications were safely reduced or discontinued following documented improvements in weight and blood glucose.

While 6.3% may appear modest, the study's authors note that the reductions did not occur within an intensive lifestyle intervention, specialty clinic, or structured medication reduction program. They emerged organically during routine primary care visits, where patients were required only to have at least two clinical encounters to be included in the chart review.

If similar outcomes were replicated nationally among the 38 million Americans living with type 2 diabetes, even a 6% deprescribing rate could translate into millions of patients reducing medication burden, lowering treatment costs, and decreasing risk of medication-related side effects, the paper stated. 

"These findings add to a growing understanding of how deprescribing can be approached in primary care," said Gia Merlo, MD, MBA, MEd, DipABLM, FACLM, professor, Department of Psychiatry at NYU Grossman School of Medicine. "They suggest that when lifestyle medicine is incorporated into routine care, medication reduction may emerge as a meaningful, patient-centered outcome."

Among patients who were deprescribed and had follow‑up data available, clinically meaningful improvements were observed. Average body mass index (BMI) decreased by 2.2 kg/m², and average blood glucose levels fell by 50.5 mg/dL, both statistically significant changes.

The most common medication changes included metformin dose reduction of 34%, metformin discontinuation of 19.5%, and insulin dose reduction of 19.5%. While three adverse events were noted during chart review, investigators determined that none were attributable to the deprescribing process within the lifestyle‑informed primary care context.

Lifestyle changes were explicitly documented in just over half of deprescribed cases, most often involving dietary changes and increased physical activity. Researchers note that finding likely underestimates true lifestyle engagement, reflecting documentation practices rather than absence of behavior change.

"Future research can continue examining deprescribing outcomes following lifestyle medicine–informed care," ACLM Senior Director of Research and Quality Micaela C. Karlsen, PhD, MSPH, said. "By adopting deprescribing protocols that respond to lifestyle‑driven improvements, we have an opportunity to further advance patient‑centered, evidence‑based care for chronic disease."

About ACLM®
The American College of Lifestyle Medicine (ACLM) is the nation's medical professional society advancing the field of lifestyle medicine as the foundation of a redesigned, value-based and equitable healthcare delivery system, essential to achieving the Quintuple Aim and whole-person health. ACLM represents, advocates for, trains, certifies, and equips its members to identify and eradicate the root cause of chronic disease by optimizing modifiable risk factors. ACLM is filling the gaping void of lifestyle medicine in medical education, providing more than 1.2 million hours of lifestyle medicine education to physicians and other health professionals since 2004, while also advancing research, clinical practice and reimbursement strategies.

SOURCE American College of Lifestyle Medicine