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How do I manage my medications if I make dietary changes to improve my diabetes?

Virta Health

By Dr. Jeff Stanley

We strongly recommend that patients with type 2 diabetes consult a medical professional before making dietary changes. Changing your diet, particularly starting the personalized, well-formulated ketogenic diet utilized by Virta, can be incredibly powerful in improving blood sugar and even reversing type 2 diabetes. However, because of the rapid blood sugar and blood pressure improvements that are seen, it is very important that you have medical supervision while making dietary changes. This is particularly important in patients taking medications like insulin or sulfonylureas, which can cause dangerously low blood glucose. In addition, newer diabetes medications such as SGLT-2 inhibitors, can lead to a dangerous condition known as “euglycemic diabetic ketoacidosis,” in which patients can have normal blood glucose but dangerous changes in the acidity of their blood.

In addition, due to the rapid improvements that are often seen in blood sugar, it is important to have close monitoring of your biomarkers. This can be difficult for most clinics to provide, but is part of the continuous remote monitoring that is part of the Virta treatment. We sometimes adjust medications multiple times in one day, and often need to be proactive in reducing medications to avoid dangerous low blood sugars.

Learn more about the dietary changes required to reverse prediabetes without increasing medication in Reversing Diabetes 101 by Dr. Sarah Hallberg.


Hallberg SJ, McKenzie AL, Williams P, Bhanpuri NH, Peters AL, Campbell WW, Hazbun T, Volk B, McCarter JP, Phinney SD, Volek JS. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at One Year: An Open Label, Non-Randomized, Controlled Study. Diabetes Therapy. 2018; 9(2): 583-612. doi: 10.1007/s13300-018-0373-9.

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