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Low carb and empagliflozin
- Thread starter lcarter
- Start Date
Fenn
Well-Known Member
Hi, I think the reason they advise against it is purely because you can have DKA on these meds, if you are low carbs or keto dieting, you are by definition closer to DKA.
I low carbed properly with Jardinace which I believe is very similar to emp, they were stopped as my keytones were 3-4.
I think it’s possible but would require extreme keytone testing, I remember the keystone blood strips on the Libre sensor were £30 for ten strips, so this would be an expensive hobby, the urine test strips seem a bit unspecific to me.
I low carbed properly with Jardinace which I believe is very similar to emp, they were stopped as my keytones were 3-4.
I think it’s possible but would require extreme keytone testing, I remember the keystone blood strips on the Libre sensor were £30 for ten strips, so this would be an expensive hobby, the urine test strips seem a bit unspecific to me.
lcarter
Well-Known Member
Yes please :blush:
No worries. I only know the right spelling because I googled it.
Oops, and my initial title change was incorrect. (Sorry). Hopefully it now works.No worries. I only know the right spelling because I googled it.
MrsA2
Expert
This is the NHS warnings on a similar 'flozin'
https://www.nhs.uk/medicines/dapagliflozin/
I think for T2s that low carb is possible on it but to decrease carbs slowly over time so the body has time to adjust to lc with the medication, I.e don't cut out carbs overnight, do it over weeks/months instead.
https://www.nhs.uk/medicines/dapagliflozin/
I think for T2s that low carb is possible on it but to decrease carbs slowly over time so the body has time to adjust to lc with the medication, I.e don't cut out carbs overnight, do it over weeks/months instead.
Oldvatr
Expert
From what I see in that NHS article, it seems that carbs are needed to feed the medicine dose. Bit like insulin, you have to (in this case for a 'gliflozin) eat to the pills. The consequence seems to be possible hypo. if you are prepared for hypo's then LC diet should be ok but may need other meds adjusted.
The corollary of this advice is that drivers need to follow the DVLA guidance for diabetics on hypoglycemic medications since these meds seem to be similar to the sulfonylurea meds. Even if this is the only med you take for diabetes, It can replace Metformin apparently.
Looking at section 8 it seems I tick all the boxes and should not be taking Dapagliflozin at all. I have a heart condition and am a stroke survivor. But my heart consultant has insisted I take it. So far I have only suffered new back pain and dizziness in the side effects dept. I have the DKA test kit in the bathroom. Since I am not using ketosis or serious fasting, any ketones showing up is an attention-getter for me. I am conversant with hypo's so no bother there.
The corollary of this advice is that drivers need to follow the DVLA guidance for diabetics on hypoglycemic medications since these meds seem to be similar to the sulfonylurea meds. Even if this is the only med you take for diabetes, It can replace Metformin apparently.
Looking at section 8 it seems I tick all the boxes and should not be taking Dapagliflozin at all. I have a heart condition and am a stroke survivor. But my heart consultant has insisted I take it. So far I have only suffered new back pain and dizziness in the side effects dept. I have the DKA test kit in the bathroom. Since I am not using ketosis or serious fasting, any ketones showing up is an attention-getter for me. I am conversant with hypo's so no bother there.
bellapodus
Well-Known Member
Personally, the combo of low carb and Empagliflozin sent me into DKA with ketones of 8.5. I was in hospital for 5 days. Be cautious
Oldvatr
Expert
Here is a more detailed study of eu-DKA
https://journals.lww.com/md-journal...flozin_associated_euglycemic_diabetic.50.aspx
This is what WebMD advises against taking Dapagliflozin.
https://www.webmd.com/drugs/2/drug-165641/farxiga-oral/details/list-contraindications
Note that the first mention is #Low Blood sugar, which is interesting. As I said previously, this is a medication you need to feed with carbs. The problem is that it apparently increases glucagon enzyme which causes a form of ketosis that is uncontrolled because the mechanism is blocked by the other actions it has on the kidneys. So it reduces glucose and steps up lipid burning without the usual natural controls.
So if you are doing LC diets when taking this medication - EAT CARBS!
Edit to add: eu-DKA occurs at BGL levels above 10 mmol/l but below the T1D levels of 20+. In other words, low blood levels start at 10 mmol/l and below so anyone controlling in the normal or prediabetic ranges is at great risk of DKA. WARNING (?????) This is not mentioned in the patient's pamphlet.
https://journals.lww.com/md-journal...flozin_associated_euglycemic_diabetic.50.aspx
This is what WebMD advises against taking Dapagliflozin.
https://www.webmd.com/drugs/2/drug-165641/farxiga-oral/details/list-contraindications
Note that the first mention is #Low Blood sugar, which is interesting. As I said previously, this is a medication you need to feed with carbs. The problem is that it apparently increases glucagon enzyme which causes a form of ketosis that is uncontrolled because the mechanism is blocked by the other actions it has on the kidneys. So it reduces glucose and steps up lipid burning without the usual natural controls.
So if you are doing LC diets when taking this medication - EAT CARBS!
Edit to add: eu-DKA occurs at BGL levels above 10 mmol/l but below the T1D levels of 20+. In other words, low blood levels start at 10 mmol/l and below so anyone controlling in the normal or prediabetic ranges is at great risk of DKA. WARNING (?????) This is not mentioned in the patient's pamphlet.
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HSSS
Expert
There was a thread a few months back on this issue, where the poster had a euglycemic dka as a result of mixing a flozin and low carb. There’s a higher risk of dka when on these meds compared to the others. If I remember the name or find it I’ll update the post
this one https://www.diabetes.co.uk/forum/th...-x-toast-x-4hrs-14-6mmol.180745/#post-2382979
this one https://www.diabetes.co.uk/forum/th...-x-toast-x-4hrs-14-6mmol.180745/#post-2382979
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Oldvatr
Expert
I was recently put onto Forxiga as a heart medication to replace the Metformin I used to be on. Recently I have noticed that I can taste raspberries, and my daughter remarked that she can smell raspberries, and I made a joke about it being the new laundry conditioner.
Thinking about it I have now tested myself and my ketones register around 0,5 mmol.l, and my bgl is around 7 mmol/l. I am not in nutritional ketosis because I recently ate a carby meal. Ergo - the beast is waking up.
Thinking about it I have now tested myself and my ketones register around 0,5 mmol.l, and my bgl is around 7 mmol/l. I am not in nutritional ketosis because I recently ate a carby meal. Ergo - the beast is waking up.
