This question only applies to pre-diabetes and type 2 diabetes b/c the very nature of type 1 diabetes requires the use of insulin. The critical point to reverse type 2 diabetes is upon diagnosis when the doctor likely prescribes you metformin as the first medication and tells you to diet and exercise.
This is where the road forks and you have the chance to go left or right. If you go one way down the road and effectively implement lifestyle changes, you can reverse diabetes, put it into remission, get your A1c below 6.5 or 5.7%. End of story. No more meds. You just saved yourself from medication misery and being tortured by our health care system.
If you choose to NOT make any changes in your lifestyle, or just go for a few walks here and there and throw in some fruit on occasion, you will have to take meds for the rest of your life. Type 2 diabetes will get worse because it is a lifestyle disease. If you don’t change your lifestyle, you’ll inevitably require more medication to sweep all the trash under the rug, as it were.
Metformin is just the start. As the disease gets worse, another medication will be required to lower your A1c. If you weren’t already on blood pressure medication, that will come soon enough because type 2 diabetes and high blood pressure go together like spaghetti and meatballs. Moreover, it’s unicorn-rare to see someone on just one blood pressure medication; at least two is standard. If your doctor didn’t start you on cholesterol medication at your first visit so as to not overwhelm you with medication the first time around, he or she will eventually. It’s a guarantee for even if your cholesterol is “normal.” I haven’t even gotten started on a pill to protect your kidneys.
The medications easily add up to 5 or 6 meds IN THE BEGINNING. I’m not trying to be scary or suggesting you don’t need to take these. I want you to know you don’t have to go down that fork in the road if you choose not to.
Focused lifestyle interventions have been proven to put type 2 diabetes into remission. I hope you choose changing your lifestyle!