Which Foods Slow Down Or Speed Up the Affect of Your Type 2 Diabetes Medications?

It really is very easy for Type 2 diabetics especially, to fall into the rut of thinking of food only as a source of carbohydrate, protein, and fat.

Plants foods, in particular, also contain various chemical compounds that interact with enzymes in your liver, the same enzymes the liver uses to detoxify or destroy the active chemicals in your diabetes medications. But it is to your advantage to know some foods can accelerate the recycling of the active ingredient in a diabetes medication or slow down the recycling of the active ingredient in a diabetes medication, making blood sugar levels unexpectedly high or unexpectedly low.

The question of which food affects which medication in which way, depends on the enzymes the liver uses. Here is an overview of interactions of medications commonly used by Type 2 diabetics and the foods you eat that affect how the liver processes them.

1. Metformin: Metformin (Glucophage) is not processed by your liver. The body’s use of metformin is unaffected by food.

2. Sulfonylureas: These are processed in your liver with the help of an enzyme called cytochrome P450. Ginger, licorice, and hot peppers contain chemical compounds and are also cleared with the help of this enzyme, so eating ginger, licorice, hot peppers, or especially grapefruit will prolong the effects of sulfonylureas in your body. Eating these foods when you take the medication is like taking a higher dose of the medication, which may result in unexpectedly low blood sugars.

Some of the brand names for sulfonyureas are:

  • chlorpropamide (Diabinese)
  • glimepiride (Amaryl)
  • glipizide (Minodiab, Glucotrol)
  • tolbutamide (Orinase)
  • glibenclamide (Daonil, Euglucon)
  • gliclazide (Diamicron).

3. Vildagliptin: Vildagliptin which is marketed under the trade name Galvus, is processed in your liver with cytochrome P450, but only to a very limited extent. Eating ginger, licorice, hot peppers, or grapefruit have a slight impact on how the body uses Galvus, slightly increasing its blood sugar lowering effects.

4. Sitagliptin: Sitagliptin is marketed under the trade name Januvia, and is processed in the liver with the enzymes CYP3A4 and CYP2C8. Many fruits and fruit juices interfere with the action of these enzymes and increase the risk of side effects from taking the drugs. Juices to be avoided include grapefruit, wild mulberry, pomegranate, wild grape, starfruit, pawpaw, orange, mango, rambutan, kiwi, dragon fruit, and passion fruit. Pomegranate juice also interacts with some statin drugs for cholesterol commonly prescribed to people with Type 2 diabetes.

5. Pioglitazone: This is sold under the trade name Actos, and is cleared out of the body with the help of the enzyme CYP2C8. All of the fruits and fruit juices that interfere with the clearance of Januvia also interfere with the clearance of Actos, but especially pomegranate juice.

6. Rosiglitazone: Rosiglitazone, sold under the trade name Avandia, is also cleared out of the body with the help of the enzyme CYP2C8. Its side effects are likewise greater when the user drinks pomegranate juice.

Don’t forget, diabetes medications work best when combined with a program of lifestyle changes which includes modifications in:

  • the type of food you eat and the amount
  • an increase in physical activity, and
  • a reduction in stress

Diabetes drugs are not a cure… most of them work for a while, often several years, and then slowly lose their effectiveness. When the drugs no longer provide control of your blood sugar levels, you will then look at using insulin.