Creatine for diabetics: is it safe?
Probably, if you have type 2 and healthy kidneys. A small 12-week trial found no kidney harm. But creatine can make your yearly kidney blood test look worse than it is.
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Is creatine safe for diabetics?
For type 2 diabetes with healthy kidneys, the best evidence says probably. In one trial, adults with type 2 took 5 g of creatine a day or a dummy powder for 12 weeks. Everyone also followed an exercise plan.
A direct test of how well the kidneys filter showed no change. Protein in the urine, often an early sign of kidney disease, didn’t change either. Side effects were much the same in both groups.
That trial was small and short. A review of three trials, 87 people in all, found no major side effects but rated the evidence low certainty.
| If you have | What the studies show | Before you start |
|---|---|---|
| Type 2, healthy kidneys | No kidney harm at 5 g a day for 12 weeks, with exercise. | Tell your diabetes team. |
| Type 1 | No trials found. | Ask your diabetes team first. |
| Insulin | Results may not apply to people on insulin. | Ask your diabetes team first. |
| Kidney disease | Avoid it if kidney function is very low. | Don’t start without your team. |
Sources: Gualano 2011; Pinto 2016; Nutrients 2023
The results may also not apply if you’re older, not active or your sugar is hard to control. One review says the results can’t be stretched to those groups.
Ask your diabetes team before you start, and tell them which medicines you take.
Can creatine damage your kidneys if you have diabetes?
Diabetes is why the question matters. The NHS says too much glucose in your blood can damage the tiny filters in the kidneys.
In the trial, the kidney test didn’t rely on the usual blood marker. It tracked how fast the kidneys cleared a tracer. That rate didn’t change on creatine.
Already have kidney disease? A 2023 review says it’s wise to avoid creatine if your kidney function is very low. If you’re at risk of it falling, it suggests checking your kidneys while you take it.
Kidney damage may not cause symptoms early on. So if you don’t know your last result, ask your GP surgery for it before you start.
Will creatine affect my yearly kidney test?
It can. Diabetes UK says you should normally have two kidney tests every year.
One is a urine test. The other is a blood test for a waste product called creatinine.
That blood test gives a score called eGFR. Look for that line on your results. The NHS says creatine can make it look as though your kidneys are not working normally.
Think of toast setting off a smoke alarm. The alarm is real, but there may be no fire. A low eGFR on creatine may be a false alarm, or it may not, so only your team can tell.
Your yearly kidney check on creatine
- 1
Tell them
Say you take creatine, and how much.
- 2
Urine test
Looks for protein leaking into your urine.
- 3
Blood test
Gives your eGFR. Creatine can make it look worse.
- 4
Your result
Ask if creatine could explain a low eGFR.
Sources: Diabetes UK; NHS
The NHS says to let your doctor know you’re using creatine. More on the numbers in the eGFR blood test and does creatine raise creatinine.
Does creatine lower blood sugar?
Maybe, alongside exercise. In the 12-week trial, HbA1c, the long-term blood sugar test, fell only in the creatine group.
| Group | Start | After 12 weeks |
|---|---|---|
| Creatine 5 g a day, plus exercise | 7.4% | 6.4% |
| Dummy powder, plus exercise | 7.5% | 7.6% |
Source: Gualano 2011
That’s a 1.1% bigger fall than the dummy group. But only 25 people were analysed.
A wider review, mixing healthy people and people with diabetes, found no clear effect on fasting blood sugar. Creatine on its own helped in only a few studies. The best results came with exercise.
Low blood sugar (a hypo) usually affects people on insulin or some other diabetes medicines. If that’s you, check your sugar more often when you start, and tell your team.
Creatine is not a swap for your diabetes medicine. Never stop or change a prescribed medicine without your prescriber. See blood sugar levels for diabetics for your readings.
How to take creatine if you have diabetes
Six steps for creatine with diabetes
- Ask your diabetes team first, above all if you have kidney disease or take insulin.
- Take 3 to 5 g a day. The kidney trial used 5 g.
- Keep active for at least 2.5 hours a week, walking or doing something that leaves you out of breath.
- On insulin or medicines that can cause hypos? Check your sugar more often in the first weeks.
- Tell your team you take creatine before your yearly kidney tests.
- Speak to your team if your eGFR or urine test changes after you start.
Sources: ISSN; NHS; Diabetes UK
The NHS suggests that much activity for type 2 diabetes. It matters here too, because the trial results all came with exercise.
Your weight may creep up. Weight gain is the only side effect studies report consistently. See creatine and weight gain.
For timing and doses, see how much creatine per day and creatine benefits and side effects.
When to speak to a GP
Speak to a GP or your diabetes team if:
- Your eGFR or urine test changes after you start creatine.
- You have kidney disease and want to try creatine.
- You get hypos often, you’ve had severe hypos or you’ve had hypos at night.
- You feel really tired, have swollen ankles, feet or hands, or are short of breath.
- You feel sick, lose weight or appetite, wee more at night, or have itchy skin or muscle cramps.
Call 999 or go to A&E if you have type 2 and you’re peeing a lot, feel very thirsty or feel sick. The same goes if you feel confused, very sleepy or drowsy, or you get short of breath.
Call 999 if someone with very low blood sugar is unconscious or not responding normally. Do this if there’s no glucagon injection or you don’t know how to use it. Also call if it hasn’t worked within 10 minutes, or they’ve been drinking alcohol.