Medication Deprescribing Practices Among Lifestyle Medicine Providers: A Cross-Sectional Survey

Abstract

When effectively implemented, lifestyle interventions can lead to significant improvements in glycemic control, often reducing the need for glucose-lowering medications. However, guidance on deprescribing these medications following lifestyle changes remains limited. This study aims to characterize the deprescribing practices of lifestyle medicine clinicians for glucose-lowering medications in patients with T2D who undergo lifestyle interventions. A cross-sectional survey assessing provider demographics, deprescribing protocols, monitoring practices, and follow-up approaches was conducted among lifestyle medicine clinicians with prescriptive authority or involvement in therapeutic decision-making. Data were analyzed using descriptive statistics, and qualitative themes from open-ended responses were summarized. A total of 67 providers completed the survey. More than half (53%) reported having no established protocol for deprescribing diabetes medications, although respondents detailed individualized approaches based on glucose monitoring and patient progress. Providers most frequently deprescribed medications associated with hypoglycemia risk first (e.g., sulfonylureas and meal-time insulin). Common monitoring strategies included hemoglobin A1c (99%), fasting lipid profiles (86%), and continuous glucose monitoring (59% preferred). Hypoglycemia was reported as rare or uncommon in patients undergoing lifestyle medicine treatment. Conclusions: Despite the absence of standardized protocols, lifestyle medicine clinicians consistently employ patient-centered strategies to adjust medications based on individual response to lifestyle interventions.