Managing Diabetes and Warfarin

By: Alere Staff

It takes a great level of discipline to manage and monitor an ongoing disease like diabetes, a disorder of the body’s metabolism. In a person who does not have diabetes, the pancreas produces the correct amount of insulin to move glucose, sugar’s form in the blood, from the blood to the cells. In diabetes, however, the pancreas does not produce enough insulin or the cells within your body’s organs do not use insulin properly.1 According to the National Institute of Diabetes and Digestive and Kidney Disease, healthy eating can help manage your diabetes by controlling your blood sugar. This means that every day you must poke your finger, sometimes more than once, to test your blood sugar level. You also must be conscientious of what you eat and drink as even having too much water could drop your blood sugar levels.

If you are a person who manages a condition like diabetes as well as taking warfarin, then you are aware of how much more work it can be. Diabetes itself is a risk factor for conditions like heart disease and stroke, so having both conditions is not uncommon.1 Here are some facts and tips that may make managing both diagnosis easier.

Warfarin, Diabetes and Diet

Let’s start with diet. Both managing diabetes and taking warfarin involve close monitoring of what you are eating. With diabetes you must monitor your carbohydrate intake. Carbohydrates provide energy for our bodies but if we eat too much our body will conserve the energy as sugar for later use. If a diabetic eats too many carbohydrates, their bodies will have an overabundance of sugar, or glucose, in the blood system, leading to complications.1

This does not mean you are doomed to a bland diet. Meats, fish and poultry are perfectly fine but it’s all in the preparation. For example, bake your chicken, don’t fry it. The intense heat destroys a lot of the nutrients your body would otherwise use. As a patient on warfarin, it is again important for you to pay attention to what foods you eat and beverages you drink. Vitamin K is in many foods you may eat and it can have an effect on how warfarin is processed in your body. For example, spinach is loaded with lots of nutrients, one of which is vitamin K. While a spinach salad may be good for diabetes, the vitamin K may affect your INR. While physicians agree that you can continue to enjoy foods containing vitamin K, being consistent is key. Be sure to avoid drastic changes in your vitamin K intake.For a list of vitamin K content in foods, please see our Vitamin K Finder.

Getting Enough Exercise

As with many other conditions, when managing both warfarin and diabetes it is recommended to include a healthy amount of exercise. Making sure you get enough movement each week will keep your blood moving and your heart healthy and can aid in keeping the body’s systems functioning. According to the Department of Health and Human Services, it’s best to get at least two hours and thirty minutes of a moderate level aerobic activity, or one hour and 15 minutes of a vigorous level of aerobic activity, a week.Also, making sure you spend at least two days a week strengthening your muscles and including many of your major muscles groups like your stomach, back and arms. Repetition of at least 8 to 12 times of each exercise per workout session is suggested.3

Medication Management

Managing your different medications for each condition can also be a challenging experience. At this time, there have been no interactions reported between warfarin and diabetic medications.2 Keeping a log or calendar of dose information can help keep you organized. You can also use a pill box to keep your medications in order. Be sure to share any medication changes with your doctor(s), especially if you have multiple physicians involved in your care.

While managing anticoagulation and diabetes can be challenging, it doesn’t mean you cannot enjoy your life. With careful monitoring and help from your doctor, you can manage both conditions and still live your life to the fullest. Just remember to be proactive in your health.


  1. National Institute of Diabetes and Digestive and Kidney Disease. Diabetes, Heart Disease and Stroke. NIH Publication No. 13-5094. August 2013. Retrieved from website:
  2. Bristol-Myers Squibb Company. Medication Guide for Coumadin Tablets and Coumadin for Injection [Package Insert]. Princeton, NJ: Bristol-Myers Squibb Company. 2015.
  3. Department of Health and Human Services. Be Active Your Way: A Guide for Adults. ODPHP Publication No. U0037, October 2008. Retrieved from website: