An immediate start on medication is not inevitable even with initial high BG levels. It depends on the individual. In my case, my BG reading on diagnosis was over 20 (possibly extra high due to stress!) and I already had retinopathy, indicating high BG for a considerable time. The DSN advised treatment by diet and exercise only but said she thought I would need medication almost immediately because of the high BG figure, likely duration and "you are slim". Hmmmm ....... nice of her to say that but at 74kg and 1.65m tall, I don't think so!
Six months later my BG levels are usually 4 - 5, I weigh around 55kg and my second HbA1c was 6% (early September) having dropped from 12.4% (early May). I attribute this to smaller portion sizes, restricted carb intake, helpful advice on this forum, and my exercise bike.
The main thing is to do whatever it takes, whether medication or not, to get BG down. When that's sorted, medication might be reduced or stopped altogether.
Best wishes
MaryChristine