Drug & supplement interaction

Ketogenic Diet + Insulin Aspart

Insulin Aspart brand name: Fiasp.

Moderate Interaction
The bottom line Moderate

Ketogenic Diet has a moderate interaction with Insulin Aspart. Theoretically, following the ketogenic diet while using antidiabetes drugs might increase the risk of hypoglycemia.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Ketogenic Diet and Insulin Aspart

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIDIABETES DRUGS

Why this applies to Insulin Aspart

Insulin Aspart falls under ANTIDIABETES DRUGS — the group Ketogenic Diet interacts with.

Theoretically, following the ketogenic diet while using antidiabetes drugs might increase the risk of hypoglycemia.
The ketogenic diet involves a very low intake of carbohydrates, which can result in decreased blood glucose levels in patients taking antidiabetes drugs. In some patients, the need for antidiabetes drugs is reduced. Hypoglycemia has also occurred in some individuals without diabetes, although this is uncommon.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing to understand: insulin aspart (Fiasp) is a fast-acting mealtime insulin. You dose it based on the carbs you're about to eat. A ketogenic diet keeps carbs very low, so your meals push your blood sugar up much less than usual. If your insulin dose stays the same while the carbs drop, you can end up with too much insulin for too little sugar, which means hypoglycemia (low blood sugar). Watch for shakiness, sweating, confusion, a racing heart, or feeling suddenly weak.

This isn't a chemical clash between the diet and the drug, it's a balance issue, and it's very real with mealtime insulin. Please don't change your dose on your own. Check your sugars more often and talk with your doctor or pharmacist before starting keto so they can adjust safely.

References
  1. Liu H, Yang Y, Wang Y, et al. Ketogenic diet for treatment of intractable epilepsy in adults: A meta-analysis of observational studies. Epilepsia Open. 2018;3(1):9-17. PubMed
  2. Yancy WS Jr, Westman EC, McDuffie JR, et al. A randomized trial of a low-carbohydrate diet vs orlistat plus a low-fat diet for weight loss. Arch Intern Med. 2010;170(2):136-45. PubMed
  3. Goday A, Bellido D, Sajoux I, et al. Short-term safety, tolerability and efficacy of a very low-calorie-ketogenic diet interventional weight loss program versus hypocaloric diet in patients with type 2 diabetes mellitus. Nutr Diabetes. 2016;6(9):e230. PubMed
  4. Saslow LR, Mason AE, Kim S, et al. An online intervention comparing a very low-carbohydrate ketogenic diet and lifestyle recommendations versus a plate method diet in overweight individuals with type 2 diabetes: A randomized controlled trial. J Med Intern
  5. Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition. 2012;28(10):1016-21. PubMed
  6. Cervenka MC, Hocker S, Koenig M, et al. Phase I/II multicenter ketogenic diet study for adult superrefractory status epilepticus. Neurology. 2017;88(10):938-943. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Ketogenic Diet Also Interacts With Other Medications

Ketogenic Diet has 136 moderate, 122 minor known drug interactions in our database — the Insulin Aspart one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Ketogenic Diet

Covers the 2,830 medications we’ve checked against Ketogenic Diet. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Insulin Aspart

This page covers Ketogenic Diet only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Insulin Aspart page lists 239 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Siberian Cocklebur (major), Acai (moderate), African Wild Potato (moderate), Agaricus Mushroom (moderate) and Agmatine (moderate).

By severity: 1 major · 208 moderate · 30 minor.

From our pharmacist’s overview on the Insulin Aspart page

“Every one of the 239 supplements listed for insulin aspart (Fiasp) touches the same thing the drug exists to manage, blood sugar, so this list warrants genuine care rather than a quick skim. Most entries add to insulin's glucose-lowering effect, raising the risk of hypoglycemia, and with a rapid-acting mealtime insulin a low can become…”

Reviewed by 2 · Jul 18, 2026

Open the Insulin Aspart interaction page

How much people look this up

Where Ketogenic Diet and Insulin Aspart Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ketogenic Diet
Steady interest

#1,196 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Insulin Aspart
Steady interest

#1,825 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Eating pattern

About Ketogenic Diet

What is Ketogenic Diet?

  • Weight loss
  • Type 2 diabetes and blood sugar control
  • Drug-resistant epilepsy (especially in children)
  • Reducing appetite
  • Athletic and metabolic interest

The ketogenic diet is a very low-carbohydrate, high-fat eating plan that shifts the body to burn fat for fuel. It has the strongest evidence as a medical therapy for hard-to-treat epilepsy and may help short-term weight loss and blood sugar, but it can be hard to sustain and is not right for everyone. Talk with a doctor or pharmacist before starting, especially if you have a medical condition or take medication.

Read the full Ketogenic Diet monograph & all interactions
Medication

About Insulin Aspart (rDNA Origin) Injection

What Is Insulin Aspart (rDNA Origin) Injection Used For?

Brand name: Fiasp

Insulin aspart is used to improve blood sugar (glucose) control in people with diabetes mellitus. It is approved for both type 1 and type 2 diabetes in adults, and for diabetes mellitus in pediatric patients.

Insulin Aspart Protamine and Insulin Aspart Mix 70/30 is a pre-mixed product that combines a rapid-acting and an intermediate-acting insulin aspart. It is approved to improve blood sugar control in adult patients with diabetes mellitus. It is not recommended for treating diabetic ketoacidosis, and because its ratio of rapid-acting to intermediate-acting insulin is fixed, it does not allow for separate mealtime versus background dose adjustments.

See full Insulin Aspart (rDNA Origin) Injection drug information
Keep checking

Other Drugs & Ketogenic Diet

Browse every other medication we’ve checked against Ketogenic Diet — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
136Moderate
122Minor
2,571No known interaction
Moderate

136 interactions

Showing 60 of 136 moderate interactions — see all 136 on the Ketogenic Diet page.

Minor

122 interactions

Showing 60 of 122 minor interactions — see all 122 on the Ketogenic Diet page.

No interaction 2,571 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Following Ketogenic Diet While Taking Insulin Aspart: Common Questions

Can you follow Ketogenic Diet while taking Insulin Aspart?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Ketogenic Diet and Insulin Aspart interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.