13
MEDICATION MANAGEMENT
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Diabetes medications—insulin and sulfonylureas: Doses should
be REDUCED or STOPPED BEFORE starting a low-carb diet to
prevent hypoglycemia (low blood sugar).
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Metformin: Can be used in a low-carb diet.
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Blood pressure medications: A low-carb diet can improve blood
pressure. If you have a pressure below 110 mmHg, headache, or
feel lightheaded, your blood pressure medications may need to
be changed. Diuretics especially should be reduced.
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Blood thinners: Coumadin (warfarin) should be monitored more
frequently when transitioning to a low-carb diet, especially if
vegetable-intake changes.
Insulin should be adjusted down and sulfonylureas (i.e., glipizide/
glyburide) should be stopped ON THE SAME DAY that you are
starting the new eating plan.
As weight loss continues, blood glucose levels will decline and further
medication reductions may be necessary.
As you improve your insulin resistance, medications which can lower
blood glucose will likely need to be reduced or eliminated. Check your
blood sugar regularly! Blood pressure can improve also, so monitor
with a home cuff and consult with your doctor.
• Reducing carbohydrate intake
potently reduces blood glucose
level, which means that diabetes
medications can be reduced or
even stopped in some cases.
• Reducing carbohydrate intake also
leads to water loss. As a result,
blood pressure can decrease and
dehydration can occur if water
and sodium are not replenished,
especially if you are taking a diuretic.
It is VERY important when following a low-carbohydrate nutrition therapy to
adjust medications to minimize the risk for hypoglycemia and hypotension.
Consult with your physician. Checking your blood glucose and blood pressure
at home is essential.
Monitoring and Adjusting Medications
