Medical Disclaimer: Never change your diabetes medication without consulting your GP or diabetes care team. This article provides general information only.
Metformin is the world’s most prescribed diabetes medication. Many people with type 2 diabetes wonder whether they can start keto while taking metformin — and whether doses need adjusting.
There is no fundamental incompatibility between keto and metformin. Both reduce blood glucose, and many people safely take metformin while following a ketogenic diet under medical supervision.
As keto significantly reduces blood glucose — often to levels previously requiring medication — metformin doses may need reducing over time. Under-adjustment risks hypoglycaemia (dangerously low blood sugar). Over-adjustment risks hyperglycaemia.
Very rarely, metformin can cause lactic acidosis — a serious metabolic complication. The risk is theoretical on keto if carbohydrates are very low and calorie intake insufficient. This is not well-documented in practice.
Test blood glucose at least twice daily when starting keto on metformin. Report readings to your GP regularly. Seek immediate medical advice if feeling unwell.
Build your diabetic keto foundation with our keto salads and keto main dishes.