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Low carb and empagliflozin

Discussion in 'Low-carb Diet Forum' started by lcarter, Sep 22, 2021.

  1. lcarter

    lcarter Type 2 · Well-Known Member

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    Hi does anyone low carb on this drug? I’ve been advised against it but I was wondering if anyone does, and if so, how low is safe to go from experience? Thanks
     
  2. lessci

    lessci Type 2 · Well-Known Member

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    I'm on dapagliflozin and (try to) low carb, I don't count, but avoid the usual suspects
     
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  3. Fenn

    Fenn Type 1.5 · Well-Known Member

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    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.
     
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  4. EllieM

    EllieM Type 1 · Moderator
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    Would you like me or another mod to change the title of your thread to empagliflozin?
     
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  5. lcarter

    lcarter Type 2 · Well-Known Member

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    Yes please :blush:
     
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  6. EllieM

    EllieM Type 1 · Moderator
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    No worries. I only know the right spelling because I googled it. :)
     
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  7. EllieM

    EllieM Type 1 · Moderator
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    Oops, and my initial title change was incorrect. (Sorry). Hopefully it now works.
     
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  8. MrsA2

    MrsA2 Type 2 · Well-Known Member

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    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.
     
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  9. Oldvatr

    Oldvatr Type 2 · Expert

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    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.
     
  10. bellapodus

    bellapodus Type 2 · Well-Known Member

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    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
     
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  11. Oldvatr

    Oldvatr Type 2 · Expert

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    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.
     
    #11 Oldvatr, Sep 23, 2021 at 9:05 PM
    Last edited: Sep 23, 2021
  12. HSSS

    HSSS Type 2 · Expert

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    #12 HSSS, Sep 23, 2021 at 9:06 PM
    Last edited: Sep 23, 2021
  13. Oldvatr

    Oldvatr Type 2 · Expert

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    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.
     
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