PATIENT EDUCATION
Before starting a diet
Your eating plan needs to work with your medical conditions and the medications you take. An online recipe cannot replace that assessment.
Assessment comes first
If you have diabetes or kidney disease, request a comprehensive medical assessment before starting any weight-loss diet, including low-carbohydrate, keto, carnivore or fasting plans, or replacing meals with shakes. This does not mean you should stop eating while you wait: continue your usual plan and your care team’s instructions.
The assessment should consider your history and symptoms, diabetes type, episodes of low blood glucose, medications and supplements, kidney function and other conditions. Laboratory tests, blood pressure, nutritional status and follow-up needs are assessed individually.
Insulin and other diabetes medications
Changing carbohydrate intake, skipping meals or increasing physical activity can change your treatment needs. Insulin and sulfonylureas can cause hypoglycemia; the risk depends on the medication, food intake and activity. Not all medications carry the same risk.
SGLT2 inhibitors, such as empagliflozin or dapagliflozin, require particular caution with keto diets, marked carbohydrate restriction or fasting because of the risk of ketoacidosis, even without very high glucose. Do not start these plans without speaking with your prescriber.
Do not stop, reduce or change doses on your own; in particular, do not omit the insulin you need. Before starting, agree on how to monitor glucose, recognize and treat low blood glucose, when to seek help and how follow-up will work. Medication changes are decided by your treating professional.
Kidney disease: protein needs are individual too
A high-protein diet or a 60 g shake is not automatically appropriate because you want to build muscle. Needs change with kidney function, disease stage, nutritional status and whether you receive dialysis.
Your doctor and dietitian should determine your protein intake and whether sodium, potassium, phosphorus or fluids need adjusting. People with kidney disease do not all need the same restrictions. Bring shake, supplement and salt-substitute labels to your visit.
What to bring to your appointment
Bring a list of medications with doses and schedules, supplements, glucose records if available, recent laboratory results and the eating plan you want to follow. Mention appetite changes, unintentional weight loss, weakness or difficulty rising from a chair.
Your plan should include health goals, muscle preservation, adequate nutrition and follow-up, as well as weight. These pages provide general education; they do not authorize a diet or medication adjustment for an individual patient.
You may also find useful
Strength and muscle ↗Sources and scope
General education for adults, updated in October 2026. Starting amounts and adaptations are a conservative suggestion based on the sources’ principles, not a routine validated for every condition. This does not replace medical assessment or individual physical therapy.
