For most of my career, I have watched people with type 2 diabetes hear the same forecast. The disease is progressive. One pill becomes two, and eventually, for many, insulin follows. Many patients decide nothing they do will change the ending.

About 40 million Americans have diabetes, and that forecast helps explain why treatment has narrowed so quickly to drugs. About 4 in 10 adults with diabetes say they have taken a GLP-1 medication such as Ozempic. These drugs work, and I prescribe them. But the story that made them seem like the only real option leaves out how the disease often starts, and what food can do about it.

The gap is being filled by something else. Nearly half of GLP-1 users have started new vitamins or supplements, according to a Nutrition Business Journal survey recently cited by Reuters. Some spend $200 to $300 a month on fiber, collagen and electrolytes to manage side effects. TikTok Shop alone sold more than $1 billion in supplements in 2025, much of it promoted by influencers.

Supplements are not approved by the Food and Drug Administration before they are sold, and regulators are now weighing tighter rules.

People seeking cheaper versions of the drugs face their own risks. On Oct. 19, USA TODAY reported a nationwide recall of compounded tirzepatide, the active ingredient in Zepbound and Mounjaro, because the pharmacy........

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