14
• Sulfonylureas (i.e., Glipizide, Glyburide, Amaryl)
Risk of weight gain and hypoglycemia.
• Meglitinides (i.e., Prandin, Starlix)
Risk of weight gain and hypoglycemia.
• SGLT2 inhibitors (i.e., Jardiance, Invokana)
Risk of euglycemic diabetic ketoacidosis.
• Bolus meal time insulin (i.e., Humalog, Apidra,
Novolog)
Risk of hypoglycemia. Might need small amounts to correct
high blood sugar.
• Combination insulins (70/30) — switch to basal
long acting (i.e., Levemir, Lantus, Tresiba, Toujeo)
• Alpha-glucosidase inhibitors (i.e., Acarbose)
Blocks glucose absorption so not needed in carb reduction.
• Biguanides (i.e., Metformin, Glucophage)
Assists with insulin resistance.
• GLP1 Agonists (i.e., Ozempic, Victoza, Trulicity)
Can suppress appetite and assists in weight loss.
• DPP4 Inhibitors (i.e., Januvia, Tradjenta)
Effects similar to GLP1 but not as potent.
When reducing medication, you must be checking
your blood glucose frequently and communicating
with your clinician.
• Basal long acting insulins (see brand above) —
may need to reduce dose by up to 50%.
Follow blood sugars and adjust as needed
• Thiazolidinediones (i.e., Actos, Avandia)
Contributes to weight gain.
Figure 2. Adapting Diabetes Medication for Low-carb
Management of Type 2 Diabetes
Source: Murdoch C., Cucuzzella M., et al. British Journal of General Practice 2019; 69; 360-361
STOP
REDUCE
CAUTION
SAFE
