Hi Fernsk. Seems like you have two different questions or assumptions represented here, and neither of them have a simple, correct answer. Before anything, welcome! I know you probably don’t want to be here, but there is a lot of experience with dealing with diabetes in this forum. So, on to your actual post:
May I ask why? For most diabetics, medication is necessary (at some point) in order to achieve healthy blood sugar or maintain healthy blood sugar. Achieving and maintaining healthy blood sugars is absolutely, critically important for diabetics of any type, since high blood sugars are directly or indirectly responsible for the complications that can make diabetes such a terrible thing. Everything from blood vessel issues in the eyes to loss of sensation in the extremities (neuropathy) to CV damage, stroke, and heart attacks result from consistently high blood sugars. Really high blood sugars can result in diabetic ketoacidosis, which is fatal if untreated.
It is usually considered best practice to treat Type 2 with medication (either orals, insulin, or orals and insulin) to bring the BG into a “normal” range as quickly as practical, and then some people maintain that with diet and exercise if they can. Key point: not everyone (probably not even most people) can maintain “healthy” blood sugars on diet and exercise alone, although some people do so for extended lengths of time.
The most common drug used to treat initially diabetes in Type 2 cases is Metformin (or Glucophage), which is one of the most safe and well-studied drugs humans use for anything at this point. It does have some irritating GI side effects that usually subside within a few weeks, although for some people they do not (I am one of those people). It is also used in some Type 1 cases these days, and many of us here (myself included) take it to help control our diabetes.
Short answer is: it depends on the specific person. There are a lot of cases reported on blogs, in print journalism, and maybe even by word on people who successfully control or “reverse” their diabetes with diet and exercise. There are some diabetic persons who can maintain blood sugar in a healthy range using only diet and exercise, but they seem to be few and far between. Partially because the diet and exercise necessary are usually quite intense, and partially because Type 2 diabetes mellitus is progressive and will almost always get more serious over time. What works now may not work in six months or six years.
Have you consulted with a doctor? An A1c of more than 8 is definitely full-blown Type 2, and those elevated blood sugars are doing damage to your body. Most doctors will want to help you get that under control now, and then re-evaluate through time. Starting medication to help bring blood glucose down doesn’t mean you’ll be on those medications for ever. And doing well on diet and exercise doesn’t mean you’ll always do well on diet and exercise alone.
Medication is a tool in combating a really serious disease. Diet and exercise are also tools, and are necessary for most of us to live well. But few of us it is safe to say, over the long run, have been able to successfully manage our diabetes with diet and exercise alone.
For myself, I was initially diagnosed Type 2 May of last year, and between Metformin ER, diet, and exercise, quickly got into a better A1c (below 6.0%). There were some other issues, however, and it became clear with further testing that I’m not Type 2, but rather a slow-onset version of adult Type 1. So my personal experience isn’t really applicable to your case. But what I can say is this: diet and exercise are critically important to maintaining a good blood sugar range for me, but I want to use all the tools I have available. I want to live a long, healthy life, and will use whatever medications are necessary for me to do so.