From healthcentral.com
Eating the right diet can help you achieve better blood sugar control while on the medication
Taking metformin to help control your type 2 diabetes helps your body use insulin more effectively and reduces the amount of glucose made by your liver and the amount of sugar absorbed through your intestines. And it works best when it’s combined with lifestyle changes, like tweaks to your diet.
“While someone taking metformin can eat all foods, there are certain foods to limit. Eating a lower-carbohydrate, diabetic-friendly diet is important for better blood sugar while taking [the medication],” explains dietitian Rebecca Jaspan, R.D., the owner of the private nutrition practice Rebecca Jaspan Nutrition in New York City. Here’s what to limit—and what to keep—on your menu.
Why Diet Matters With Metformin
Certain foods (or drinks) such as alcohol and high-fat foods can impact the way metformin works, either leading to too-low blood sugar or making it harder for your body to absorb the drug. Additionally, the medication is meant to be used hand-in-hand with a healthy diet to control blood sugar, according to the Mayo Clinic.
“As a dietitian, I like to remind my clients that metformin works like a temporary bandage — it can help in the short term, but long-term success depends on lifestyle and diet habits. By focusing on healthy eating and daily habits, people can have better control over their blood sugar,” says dietitian Violeta Morris, R.D.N., the owner of the private nutrition practice The Concierge Dietitian in Columbus, OH.
In other words: Diet and metformin go hand in hand. Choosing healthy foods most of the time sets the stage for better blood sugar management, which will help you feel your best and lower your risk for diabetes complications in the long-term.
Foods to Avoid When Taking Metformin
Whether you’re taking metformin or not, when you’re living with diabetes, it’s best to minimize foods that are high in sugar, carbohydrates, and fat, as well as those that are highly processed. While you don’t have to steer clear completely—a handful of chips or an occasional cookie is OK—keeping these foods infrequent will make your metformin more effective, Jaspan says.
These are a few of the food categories worth limiting:
High-Sugar Foods
Eating sugary foods is like adding fuel to the fire when you already have high blood sugar. “They’re the first foods I recommend limiting or avoiding for anyone taking metformin,” Morris says. Per the American Heart Association (AHA), foods that tend to be high in added sugars include:
Baked goods
Breakfast cereal and bars
Candy
Ice cream and frozen desserts
Sweetened coffee drinks
Sweetened drinks like soda, sweet tea, energy drinks, or juice
Sweetened yogurt
High-Glycaemic Foods
High-glycaemic foods are ones that cause your blood sugar to rise quickly after eating. Foods that are high in added sugar are usually high-glycaemic, but there are also plenty of high-glycaemic foods that have little or no added sugar, Morris points out. These include carbohydrates with little to no fat or fibre, or highly processed foods, notes the National Library of Medicine.
Per the Cleveland Clinic, high-glycaemic foods are things like:
Cereal
Chips
Donuts
Potatoes or French fries
Pretzels
White bread
High-glycaemic foods have the biggest impact on your blood sugar when you eat them alone. So if you’re going to eat them, “try pairing them with protein, fibre, and healthy fat to help slow digestion and prevent blood sugar spikes,” recommends certified diabetes educator Sheri Gaw, R.D.N., a dietitian based in the San Francisco Bay Area. Dunk pretzels in peanut butter or have a baked potato with grilled chicken breast and veggies, for instance.
Alcohol
Drinking while you’re on metformin isn’t recommended, because metformin lowers your blood sugar. Alcohol can also lead to low blood sugar, since your liver stops releasing glucose when it’s busy processing alcohol. In rare instances, the combo can also lead to metformin-associated lactic acidosis, a potentially life-threatening metabolic condition where dangerously high levels of the drug build up in the body, per the National Library of Medicine.
“Although it’s best to avoid alcohol, if it is consumed, keep it in moderation and always eat food along with alcohol to help prevent dangerous blood sugar drops,” Gaw says. That’s no more than two drinks per day for men and no more than one drink per day for women.
Ultra-Processed Foods
Ultra-processed foods such as soda, candy, and packaged snacks and desserts tend to be high in simple carbs and sugar and low in fibre, so they’re likely to cause a quick blood sugar spike-and-drop, Morris points out.
That in turn can make it harder to control your diabetes. In fact, a research brief published in the Journal of the Academy of Nutrition and Dietetics found that adults with type 2 diabetes who ate more ultra-processed foods had higher A1C levels (a measure of your blood sugar over time), while those who ate more unprocessed or minimally processed foods had lower A1C levels.
High-Fat Foods
Rich, greasy fare like fried food, pastries, and fatty cuts of meat may make it harder for the body to absorb metformin, found a recent meta-analysis published in the journal Heliyon. “Because of this, someone may need a higher dose to get the same effect if they regularly eat heavy, fatty meals,” Morris says.
High-fat foods can also make you less sensitive to the blood sugar-regulating hormone insulin, which can also drive your blood sugar up. “It means less blood sugar is getting into your cells, and more is staying in the bloodstream, increasing blood glucose levels,” explains Gaw.
Excessive Salt
A very salty meal or snack (think chips, processed meat, canned soup, or frozen entrees) won’t necessarily impact your blood sugar. (Though it can, if it’s also high in refined carbs, sugar, or fat.) But it’s still important to limit your sodium intake: People with diabetes are more likely to have high blood pressure, which can raise your risk for a heart attack or stroke, per Johns Hopkins Medicine.
According to the American Diabetes Association (ADA), some of the best options to reach for include:
Avocado
Beans and legumes like chickpeas, black beans, and lentils
Dark leafy greens like spinach, collards and kale
Fatty fish such as salmon or tuna
Fruit like berries and citrus
Milk and plain, unsweetened yogurt
Nuts and seeds like almonds, walnuts, and flaxseeds
Whole grains like oats, quinoa, barley, and whole wheat
What If I Ate Something I Shouldn’t?
No food is totally off limits when you’re taking metformin. But when you eat something that spikes your blood sugar, you might not feel great. To get back within range, you can:
Get some exercise. Taking a 10-minute walk after eating has been shown to lower blood sugar, according to a study published in Scientific Reports. “Even a few squats or lunges can help,” says Morris.
Drink plenty of water. Staying hydrated decreases the concentration of sugar in your bloodstream, Gaw says.
Don’t beat yourself up. “There’s no such thing as perfection, and we can’t eat perfectly all the time,” says Jaspan. Just get back on track at your next meal or snack by eating something that’s lower in carbs and higher in protein, fibre, and healthy fats.
When to Call a Doctor
You should contact your care team right away if you’re having symptoms of too-low blood sugar, per Medline Plus. These include:
Anxiety
Dizziness
Hunger
Irritability or confusion
Nervousness
Shaking
Sweating
Let your doctor know, too, if you’re experiencing metformin side effects or are still having trouble controlling your blood sugar. Together, you can come up with a plan for getting your levels under control, including making changes to your diet.
The Bottom Line
There’s no single food you need to avoid completely when you’re taking metformin. But eating a nutritious, high-quality diet is important to help the medication work, to keep blood sugar levels stable, and to keep you healthy. By limiting certain foods and prioritizing others, you’ll make your meds work more effectively to get more control over your blood sugar.
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