Diabetes Patients Often Maintained Insulin Use Despite New Drugs
A study of older veterans found that many patients did not successfully discontinue insulin after starting newer diabetes medications.
Updated on Sept. 30, 2026 in Diabetes
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A recent study of nearly 9,000 U.S. Department of Veterans Affairs patients found that only about 17% were able to discontinue insulin use after starting medications like GLP-1 agonists. The findings highlight the difficulty of phasing out insulin in older adults with elevated A1c levels.
Why it matters
Patients often look to reduce or stop insulin to avoid associated risks like weight gain and hypoglycemia. Understanding that newer medication classes do not always guarantee the successful discontinuation of insulin helps set realistic expectations for care management.
In a retrospective study of nearly 9,000 veterans older than 65 with A1c levels greater than 9%, only 17% successfully discontinued insulin. This observational analysis compared GLP-1 agonists, SGLT2 inhibitors, and DPP-4 inhibitors.
The players
U.S. Department of Veterans Affairs
A federal agency that manages healthcare services and medical research for military veterans.
The details
The study analyzed how different classes of diabetes medication might impact the need for exogenous insulin. While newer agents such as GLP-1 agonists are known for potent metabolic effects, including weight loss—with tirzepatide and semaglutide showing 20.2% and 13.7% average weight loss respectively—they did not significantly outperform SGLT2 or DPP-4 inhibitors in helping patients stop insulin. Only about 10% of the cohort was seen by an endocrinologist.
Timeline
September 2026: The study results were published in the Annals of Internal Medicine.
Health Landscape
This study adds to the ongoing research in the Annals of Internal Medicine regarding the real-world clinical effectiveness of newer diabetes therapies. It clarifies that even with highly effective metabolic drugs, tapering insulin therapy in older adults remains a complex challenge.
If you are currently taking insulin and hope to reduce your reliance on it, this study highlights the importance of maintaining a comprehensive care plan. Discuss your specific A1c goals and the suitability of different medication classes with your doctor, especially if you are over 65.
The takeaway
While newer diabetes medications offer significant benefits for weight management and metabolic health, they do not automatically replace the need for insulin in many patients. Focus on tracking your blood glucose trends and regularly consulting with your physician about the necessity of insulin therapy.
Further reading
For more on managing long-term care and treatment adjustments, explore our Diabetes section.
Source note: This article includes information reported by Medscape.
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