Expert: garlic cannot replace metformin

Dr. Pranav Ghody said on May 18 that garlic should not be treated as a substitute for metformin or for diet-and-exercise treatment in people with prediabetes or insulin resistance. In comments published by the Indian Express, the Mumbai-based endocrinologist said garlic may have general health benefits but does not have the same clinical evidence base as prescribed therapy. The article was framed as a rebuttal to “miracle food” claims around diabetes prevention. It also warned readers not to stop medication without medical advice. ### Can garlic replace metformin if someone is prediabetic? Dr. Pranav Ghody told the Indian Express that the answer is no. He said garlic cannot replace metformin or structured lifestyle treatment for prediabetes or insulin resistance, and added that its effects on blood sugar are not backed by the same level of reliable clinical evidence as standard care. The May 18 article said garlic is sometimes promoted online as a natural way to lower blood sugar. Ghody said that relying on a single food while ignoring weight control, exercise, sleep and medical follow-up can delay proper treatment. ### What did the doctor say garlic can and cannot do? Ghody said garlic “might provide health benefits,” but he drew a line between that and replacing prescribed treatment. (indianexpress.com) He told the newspaper that garlic does not have the same “reliable impact” on insulin resistance or blood sugar control as metformin, whose effects are monitored in clinical practice. The Indian Express article did not present garlic as harmful on its own. Its warning was narrower: food claims should not be turned into a reason to stop medication or skip broader lifestyle measures that doctors use to reduce progression to type 2 diabetes. ### Why is metformin used in prediabetes in the first place? Dr. Pranav Ghody said in a separate Indian Express report published four days earlier that metformin is prescribed in prediabetes because it improves insulin sensitivity and reduces excess glucose production by the liver. (indianexpress.com) He said the drug can help delay or prevent progression to type 2 diabetes when it is paired with lifestyle changes, especially in higher-risk patients. The National Institute of Diabetes and Digestive and Kidney Diseases says lifestyle therapy remains the foundation after a prediabetes diagnosis, with metformin considered for some patients who want both approaches, are not meeting weight-loss goals, or fall into higher-risk groups. (indianexpress.com) ### What do current guidelines emphasize instead of “superfoods”? The American Diabetes Association’s 2026 Standards of Care include a section on prevention or delay of diabetes and associated comorbidities, with lifestyle behavior change and pharmacologic interventions listed as the evidence-based framework. The ADA’s professional guidance describes the standards as the organization’s current clinical practice recommendations. (niddk.nih.gov) A CDC-linked evidence-based lifestyle document hosted by the ADA says Diabetes Prevention Program-style interventions focus on nutrition, physical activity and sustained behavior change over a year-long curriculum. That is the model U.S. guidance highlights, rather than a single food or supplement. ### Does this mean garlic has no role at all? (professional.diabetes.org) The Indian Express report did not say garlic must be avoided. It said garlic should not be marketed or used as a replacement for proven treatment in people with prediabetes or insulin resistance. Some studies and media reports have explored whether garlic affects fasting glucose or cholesterol, but Ghody’s point in the May 18 article was about substitution, not culinary use. (professional.diabetes.org) He said prescribed therapy and lifestyle treatment remain the standard approach. The May 18 Indian Express article remains available on the newspaper’s health section, and the ADA’s 2026 Standards of Care and NIDDK prediabetes guidance continue to be the named references clinicians use for next-step management. (indianexpress.com)