Published: 01/05/2022

How might medication management change for those who are following the Atkins Diet?

The Atkins Diet promotes both short- and long-term physiological changes and biomarker improvements; reducing or discontinuing some medications can be expected. It is recommended that people have daily accessibility to a healthcare team to allow for titrations, as warranted. Two common adjustments often needed include:

  • Reducing Diabetes Medications: Insulin and insulin secretagogues (sulfonylureas, melitinides) are particularly apt to lead to hypoglycemia and typically need to be reduced. These medications typically need to be adjusted on the same day the patient begins the Atkins Diet. Moderately elevated blood glucose levels in the 150-250 mg/dl range can be tolerated after medication reductions are made and as patients are adapting to the new eating pattern – this may “buffer” hypoglycemic episodes. As weight loss continues and glycemic control improves, further medication reductions may be necessary.
  • Adjusting Diuretics: Reducing dietary carbohydrates has a diuretic effect. This is partly a result of the breakdown of stored glycogen, which is bound to water, and partly due to decreased insulin levels, which signals the release of sodium and water from the kidneys. For patients with controlled blood pressure and/or controlled edema, the clinician may consider stopping low-dose or reducing high-dose diuretics during the first 2–4 weeks to minimize dehydration risk. Return to the prior dose if blood pressure elevates above goal and/or edema recurs.

Learn more about medication management guidelines in the Atkins resource: Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes.