Jardiance (Empagliflozin) and Food: What You Need to Know

What to Eat on Jardiance

• Consistent carbohydrate intake: Jardiance excretes approximately 70-90g of glucose per day through the kidneys — abrupt very low carbohydrate intake on top of this can cause euglycemic DKA even with normal blood sugar readings
• Adequate hydration: Jardiance increases urinary output — dehydration can cause acute kidney injury on this medication. Target at least 2 liters of fluid daily unless your physician has restricted fluids
• Potassium-containing foods if on a loop diuretic: some HF patients on Jardiance also take furosemide — the diuretic effect of both can cause significant potassium loss
• Protein adequacy: important for muscle preservation given the osmotic diuresis effects of the medication

Can I Follow a Low-Carb or Keto Diet on Jardiance?

Caution — very low carbohydrate diets combined with Jardiance significantly raise the risk of euglycemic DKA (diabetic ketoacidosis with normal or near-normal blood sugar). Jardiance increases ketone production as a metabolic effect. A very low carbohydrate diet amplifies ketone production further. The result can be DKA even when blood sugar appears normal — making it harder to recognize. If you want to follow a low-carbohydrate diet while on Jardiance, discuss this with your physician first. A modest carbohydrate reduction is safer than a strict ketogenic approach.

What to Avoid on Jardiance

• Very low carbohydrate or ketogenic diets without physician supervision: raise euglycemic DKA risk — the most serious diet-drug interaction for SGLT2 inhibitors
• Excessive alcohol: compounds dehydration risk and raises DKA risk
• Inadequate fluid intake: the increased urinary output from Jardiance requires adequate hydration — becoming dehydrated causes acute kidney injury on this medication
• High-sugar foods: Jardiance reduces blood sugar by removing glucose through urine, but high-sugar foods still overwhelm this mechanism and spike blood glucose

Jardiance and Urinary Tract Infections

Jardiance increases glucose in the urine which raises the risk of urinary tract infections and genital yeast infections. Diet does not prevent these infections directly, but staying well-hydrated helps reduce urinary glucose concentration. Minimize high-sugar foods which amplify urinary glucose excretion. Discuss any signs of UTI or yeast infection with your physician — these are common enough on SGLT2 inhibitors that any symptoms should be reported promptly.

Jardiance and Diuretics

Jardiance has a mild diuretic effect. If you also take furosemide or another loop diuretic for heart failure, the combined diuretic effect can cause significant dehydration, electrolyte depletion (potassium, sodium, magnesium), and acute kidney injury. Blood pressure may drop significantly on this combination. Monitor for dizziness, lightheadedness, and muscle cramps — symptoms of dehydration and electrolyte depletion. Your physician may need to reduce your diuretic dose when Jardiance is added.