Deprescribing and treatment alternatives in type 2 diabetes care can prove difficult in current practice due to increased patient demand and complexity. Both independent nurse prescribers and non-prescribers are often at the forefront in deciding treatment for patients with diabetes, and while guidance is available on how to initiate therapy, there is little on how and when to consider alternatives or even deprescribing. This article provides practice points and questions that general practice nurses (GPNs) can consider in the consultation process. Clinical judgement should be used throughout the process and individualised care is crucial to reducing, stopping or changing medication successfully for patients with diabetes. Through utilising the evidence, GPNs can initiate appropriate changes to patient treatment plans to optimise and promote standards of care.