NutriStack
Fenugreek and Glimepiride, a caution.
Fenugreek extracts lower fasting glucose and HbA1c in type 2 diabetes meta-analyses. Glimepiride forces pancreatic insulin release. The additive effect can produce hypoglycemia, especially in older adults, after missed meals, or with alcohol.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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What the row says.
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At a glance
- Substances
- Fenugreek and Glimepiride
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Fenugreek extracts lower fasting glucose and HbA1c in type 2 diabetes meta-analyses. Glimepiride forces pancreatic insulin release. The additive effect can produce hypoglycemia, especially in older adults, after missed meals, or with alcohol.
Mechanism. Fenugreek's 4-hydroxyisoleucine stimulates glucose-dependent insulin release, and its galactomannan fiber slows carbohydrate absorption. Glimepiride binds the SUR1/Kir6.2 K-ATP channel on beta cells to force insulin secretion. Effects are additive.
Recommendation. Do not start fenugreek on glimepiride without telling your prescriber. Check fingerstick glucose more often (before meals and at bedtime) for the first 2-4 weeks and ask whether the glimepiride dose should be reduced.
Sources (2)
- Gong J, Fang K, Dong H, Wang D, Hu M, Lu F. Effect of fenugreek on hyperglycaemia and hyperlipidemia in diabetes and prediabetes: A meta-analysis. J Ethnopharmacol. 2016;194:260-268. PMID 27496582
- Kim J, Noh W, Kim A, Choi Y, Kim YS. The Effect of Fenugreek in Type 2 Diabetes and Prediabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int J Mol Sci. 2023;24(18):13999. PMID 37762302
Stack Score
How this pair moves the number.
Effect on the composite score
If both Fenugreek and Glimepiride are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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