Nutritional Considerations

• Diabetes may be affected by many nutritional deficiencies and diabetic medications may increase the body’s nutritional needs. Glucotrol may cause a depletion of certain nutrients, especially vitamin B12. It may be beneficial to supplement the diet with a multivitamin containing adequate levels of this nutrient.

  1. "The Medical Letter on Drugs and Therapeutics," (New Rochelle, NY, The Medical Letter, Inc.) through Vol. 37 (952), July, 1995.
  2. Adams JF, Clark JS, Ireland JT, et al: Malabsorption of vitamin B12 and intrinsic factor secretion during biguanide therapy, Diabetologia, 1983, 24(1):16-8.
  3. Berger W, Incidence of severe side effects during therapy with sulfonylureas and biguanides, Horm Metab Res Suppl, 1985, 15:111-5.
  4. Rieder HP, Berger W, and Fridrich R: Vitamin status in diabetic neuropathy, Z Ernahrungswiss, 1980, 19 (1):1-13.
  5. Carpentier JL, Bury J, Luyckx A, et al: Vitamin B12 and folic acid serum levels in diabetics under various therapeutic regimens, Diabete Metab, 1976, 2(4):187-90.

• Other nutrients that could be affected by Glucotrol include co-enzyme Q10. Discuss supplementation with a pharmacist or physician before initiating supplement use because Co-Q10 may also reduce blood sugar levels. Monitor sugar levels.

  1. Kishi T, Kishi H, Watanabe T, et al: Bioenergetics in clinical medicine - studies on coenzyme Q and diabetes mellitus, J Med, 1976, 7(3-4):307-21.

• High doses of the vitamin niacin may increase blood glucose levels and excessive use of this nutrient should be avoided.

  1. Balch JF, Balch PA: Prescription for Nutritional Healing, 1997, p. 231.
  2. Pronsky, Z Food Medication Interactions, 11th edition, 1999
  3. Schwartz ML. Severe reversible hyperglycemia as a consequence of niacin therapy. Arch Intern Med. 1993 Sep 13;153(17):2050-2.

• Alcohol use should be limited since it can interfere with diabetes management.

  1. Graedon J, Graedon T: The People’s Guide to Deadly Drug Interactions, 1995, p. 284.
  2. Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
  3. Pronsky, Z Food Medication Interactions, 11th edition, 1999

• Use magnesium and vitamin E supplements with caution with patients taking glucotrol due to possible increased drug effects.

  1. McBain AM, Brown IR, Menzies DG, Campbell IW. Effects of improved glycaemic control on calcium and magnesium homeostasis in type II diabetes. J Clin Pathol 1988;41:933-35.
  2. Kivisto KT, Neuvonen PJ. Enhancement of absorption and effect of glipizide by magnesium hydroxide. Clin Pharmacol Ther 1991;49:39-43.
  3. Paolisso G, D'Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients. Am J Clin Nutr 57:650-656, 1993.

• Avoid L-carnitine and chromium with glucotrol due to possible additive hypoglycemic effects.

  1. Mingrone G. L-carnitine improves glucose disposal in type 2 diabetic patients. J Am Col Nutr 18: 77-82, 1999.
  2. Anderson RA. Nutritional factors influencing the glucose/insulin system: chromium. J Am Coll Nutr. 1997 Oct;16(5):404-10.

• Potatoes can interfere with blood sugar levels and glucotrol dosage may require adjustment.

  1. Gannon MC, et al. Diabetes Care 1993;16:874.
  2. The Review of Natural Products, Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000