Adjusting Diabetes Medications on a Low Carb Lifestyle: An MCT2D Guide

A green, yellow, and red light system for aadjusting diabetes medications like GLP-1 RAs, DPP-4i's, basal and bolus insulin, and sulfonylureas and monitoring blood glucose and adapting nutrition goals while adopting a low carb lifestyle.
A low carbohydrate (carb) lifestyle consists of reducing one’s carbohydrate intake to 50-130g of total carbohydrates per day. Patients with type 2 diabetes (T2DM) who are interested in adopting a low carbohydrate lifestyle should monitor their blood glucose carefully and work closely with their primary care team to adjust medications as needed. Risk of hypoglycemia is greatest among patients who are on insulin or sulfonylureas, particularly if they significantly reduce carbohydrate intake without adjusting their medications.
Patients with T2DM who are on these medications may need to have their medications proactively reduced (i.e., when their diet is initiated) to prevent hypoglycemia. View a detailed review on medication management for patients with T2DM who follow a low carbohydrate lifestyle by visiting or scanning the QR code. Low carbohydrate lifestyles are not ‘one-size-fits-all.’ Success may require fine-tuning and adjustments along the way to find a suitable carbohydrate range for a patient. Considerations such as patient desire/interest, experience, cultural background, and commitment to work closely with their care team and be proactive in self-management skills are necessary tools for success.
Developed by MCT2D Leadership team, including Dr. Heidi Diez, PharmD and Dr. Dina Hafez Griauzde, MD. Last modified October 2022.


PDFPoint-of-careCreated-By-MCT2DLower-CarbNon-videoFor ProvidersClinical-GuidelinesJumpstart

Subscribe to the MCT2D Newsletter

* indicates required
Blue Cross Blue Shield Blue Care Network of Michigan

Support for the Michigan Collaborative on Type 2 Diabetes is provided by Blue Cross Blue Shield of Michigan and Blue Care Network as part of the BCBSM Value Partnerships program. BCBSM’s Value Partnerships program provides clinical and executive support for all CQI programs. To learn more about Value Partnerships, visit Although Blue Cross Blue Shield of Michigan and the Michigan Collaborative on Type 2 Diabetes work in partnership, the opinions, beliefs, and viewpoints expressed by MCT2D do not necessarily reflect the opinions, beliefs, and viewpoints of BCBSM or any of its employees.