Diabetes management often involves medication to regulate blood sugar levels, but certain foods and drinks can either interfere with these medications or make it harder to maintain stable glucose levels. Here are five categories of foods and drinks to be mindful of when taking diabetes medication:

1. Sugary Drinks and Juices

Sodas, packaged juices, sweetened lassi, and energy drinks can cause rapid spikes in blood sugar. These surges counteract the effects of medications like metformin or sulfonylureas, which are designed to lower glucose levels. Instead, opt for water, sparkling water with lemon, plain chaas, or unsweetened tea or coffee. Pairing carbohydrates with protein and fiber can also help to blunt blood sugar spikes.

2. Large, High-Fat Meals

Meals very high in fat can delay gastric emptying, altering post-meal glucose patterns. This can lead to late blood sugar spikes that clash with the timing and dosage of diabetes medications. Instead, choose balanced meals with lean protein, vegetables, whole grains, and unsaturated fats. Consistent portion sizes can also help match medication timing. Fatty foods may also make it harder for your body to absorb metformin and may require a higher dose of metformin for the same effect.

3. Excess Alcohol

Alcohol can cause delayed hypoglycemia, especially when taken with insulin or sulfonylureas. It can also worsen gastrointestinal side effects associated with metformin. If you choose to drink, do so with food, set a limit (e.g., ≤1 drink per day), and monitor your blood glucose levels closely that evening and overnight. It is best to discuss alcohol intake with your doctor or pharmacist.

4. Grapefruit and Certain Drugs

Grapefruit, Seville oranges, and pomelos can inhibit intestinal CYP3A4, an enzyme that affects how the body uses certain medicines, raising blood levels of those medicines. While metformin isn't affected, many people with diabetes also take statins and some blood pressure medications that are. Grapefruit can boost the exposure to atorvastatin, simvastatin, and lovastatin, increasing the risk of side effects. If you are on these medications, discuss grapefruit intake with your doctor.

5. Simple and Refined Carbohydrates

Simple and refined carbohydrates, such as white bread, pasta, white rice, muffins, and sweetened beverages, can cause rapid increases in blood sugar, which can make diabetes medications less effective at controlling blood sugar levels. Instead of simple carbs, choose complex carbohydrates such as whole grain foods like oatmeal, brown rice, and wheat bread and combine them with proteins and healthy fats to help improve blood glucose regulation while taking diabetes medication.

It's important to remember that managing diabetes effectively involves a holistic approach. While being mindful of these food and drink interactions, people with diabetes should also focus on overall healthy eating patterns, regular physical activity, and consistent communication with their healthcare providers. A registered dietitian or certified diabetes educator can provide personalized guidance and support for navigating dietary choices and medication management.