"Creatine and diabetes" is searched about 1,700 times a month in the US, with "creatine and blood sugar" and "creatine and insulin" asking the same thing in different words. The question splits in two: does creatine harm blood-sugar control, and could it help it? The evidence for both comes down to a small number of trials, most of them from one research group in São Paulo.
This page counts what has been tested, reports each result with its population and size, and states what has not been studied. It does not say whether anyone with diabetes should take creatine — that decision depends on the person's medicines and kidneys and belongs with their clinician.
What has been tested, counted
A PubMed search on 3 November 2026 for creatine in the title crossed with diabetes, glucose, glycaemic or insulin in the title, restricted to clinical-trial publication types, returned 13 records. Read one by one:
| What the 13 records are | Count |
|---|---|
| Trials of creatine supplementation measuring glucose control | 5 |
| — of which enrolled people with diabetes | 1 (type 2) |
| Mechanism sub-study of that same type 2 cohort | 1 |
| Other: creatine-loading physiology, long COVID, lab-test, pig and kinase studies | 7 |
Five glucose trials, one in diabetes. Everything said about creatine and diabetes in consumer copy rests on that base.
| Trial | Who | Creatine | What happened to glucose |
|---|---|---|---|
| Gualano et al. 2011 | 25 people with type 2 diabetes, with exercise training, 12 weeks | 5 g/day | HbA1c −1.1 points v placebo; lower meal-test glucose; insulin unchanged |
| Gualano et al. 2008 | 22 healthy sedentary men, aerobic training, 12 weeks | ~10 g/day | Glucose-tolerance curve lower than placebo; fasting insulin and HOMA unchanged |
| Newman et al. 2003 | 17 healthy untrained men, 5 + 28 days | 20 g/day, then 3 g/day | No change in glucose tolerance or insulin sensitivity |
| Derave et al. 2003 | 33 healthy young adults, leg cast then retraining | creatine, or creatine + protein | Creatine + protein raised muscle GLUT-4 and glucose tolerance during retraining |
| Oliveira et al. 2020 | Older adults, resistance training, 12 weeks (pilot) | creatine v placebo | No difference in insulin resistance or inflammation |
The pattern the authors of a 2016 review drew from the wider literature holds in this table: where creatine moved glucose at all, it did so together with exercise, and creatine alone showed positive results "in only a few of the studies" (Pinto et al., Amino Acids 2016, PMID 27306768).
The one trial in type 2 diabetes
Gualano and colleagues randomised adults with type 2 diabetes to 5 g of creatine a day or placebo for 12 weeks, with everyone in a supervised exercise programme (Med Sci Sports Exerc 2011, PMID 20881878). Of those analysed — 13 on creatine, 12 on placebo:
- HbA1c fell from 7.4% to 6.4% on creatine and went from 7.5% to 7.6% on placebo: a difference of 1.1 percentage points (95% CI 0.4 to 1.9).
- Glucose after a test meal was lower on creatine at 0, 30 and 60 minutes.
- Insulin and C-peptide, physical capacity, blood lipids and adverse effects did not differ between the groups.
- Muscle biopsies showed more GLUT-4, the transporter that moves glucose into muscle, at the cell surface on creatine. A follow-up analysis of 10 of the patients linked this to the energy-sensing enzyme AMPK (Alves et al. 2012, PMID 22349765).
What it cannot tell anyone. It is one trial, from one group, in 25 people, for 12 weeks, and everyone exercised. It did not test creatine without exercise. It has not been repeated. The patients' existing diabetes medicines were not the question it asked, which is why the interaction side is set out separately on creatine and medications. The trial is registered as NCT00992043.
The meta-analysis that found no effect
A 2022 systematic review and meta-analysis pooled nine studies of creatine supplementation and diabetes parameters in healthy and diabetic people (Delpino & Figueiredo, Clin Nutr ESPEN 2022, PMID 35063192). Five showed some benefit on at least one measure. Pooled:
- Fasting blood glucose: standardised mean difference 0.05 (95% CI −0.53 to 0.63) — no effect.
- Insulin resistance: −0.38 (95% CI −0.90 to 0.14) — not significant.
Its authors concluded there was "an insufficient basis" to say creatine improves diabetes parameters, and asked for trials in people with diabetes. Only two of its nine studies were in people with diabetes. The two readings are not in conflict: one small trial with training found a large HbA1c change; pooling small mixed studies on fasting measures found nothing.
Kidneys: the question that comes next
Diabetes is a common cause of kidney disease, so the second question is whether creatine strains diabetic kidneys. The same São Paulo trial measured filtration directly — by chromium-51 EDTA clearance, not by estimating it from a blood marker — and found no impairment after 12 weeks; muscle phosphocreatine rose from 44 to 70 mmol/kg, confirming the patients took the creatine (Gualano et al., Eur J Appl Physiol 2011, PMID 20976468). The full figures are on creatine and kidneys.
Two limits matter more than the result. The trial excluded people with kidney disease, so it says nothing about diabetic kidney disease. And creatine raises serum creatinine without changing filtration, which makes the creatinine-based eGFR used to monitor diabetic kidneys — and to dose metformin — read lower than it is. That mechanism is explained on what creatine does to a blood test.
Type 1 diabetes: nothing published
No randomised trial of creatine in type 1 diabetes has published results. The five PubMed records that pair creatine and type 1 diabetes in the title or abstract are about creatine kinase, brain spectroscopy and immune cells, not supplementation.
On ClinicalTrials.gov, searched 3 November 2026, the creatine studies that enrolled people with diabetes are:
| Registration | Population | Status, 2026-11-03 |
|---|---|---|
| NCT00992043 | Type 2, with exercise (the São Paulo trial) | Completed, published |
| NCT06345612 | Type 1, 28 people, eccentric training in normal or low-oxygen air with creatine | Completed March 2025; no results posted |
| NCT03202095 | Depression in type 2 diabetes | Withdrawn |
| NCT06920667 | Type 2, protein-creatine-omega-3-vitamin D combination, glucose variability | Not yet recruiting |
Six other hits from the same search used creatine only as a word in a lab measure or did not give creatine at all. The type 1 study is the one to watch: it measured glucose stability, hypoglycaemia and insulin need, the outcomes a person on insulin cares about.
Adverse event reports
A query of the FDA's food and dietary-supplement adverse event database (CAERS, via openFDA) on 3 November 2026 for products whose brand name contains "creatine" returned 210 reports in total. Of those:
- 3 list blood glucose increased among the reactions; 1 lists hyperglycaemia.
- None lists hypoglycaemia, blood glucose decreased or diabetes mellitus.
The reports read for this page each name other products as well — one also names a testosterone-support capsule and tribulus, another lists liver injury and tremor. A report is a complaint filed to a database, not a finding that the product caused the event; the counts say only how rarely blood sugar appears in reports naming creatine.
Who has published a position
The International Society of Sports Nutrition, in its 2017 position stand, lists diabetes among the clinical areas where creatine has been studied and summarises the São Paulo type 2 trial as suggesting creatine with exercise "improves glycemic control" (Kreider et al., J Int Soc Sports Nutr 2017, PMID 28615996, full text read 2026-11-03). That sentence rests on the one 25-person trial above. Several of the stand's authors disclose ties to the supplement industry, set out on creatine benefits. This page did not survey diabetes-association guidance.
What is not established
- Whether creatine improves glucose control without exercise in people with diabetes.
- Whether the HbA1c result repeats in a second, larger trial.
- Anything about type 1 diabetes, gestational diabetes or diabetic kidney disease.
- How creatine behaves alongside insulin, sulfonylureas or GLP-1 drugs — no interaction study exists.
- Effects beyond 12 weeks.
Who needs to talk to a clinician first
Anyone with diabetes who is thinking about creatine, and in particular anyone on insulin or a drug that can cause low blood sugar, anyone whose medicine is dosed against HbA1c or eGFR, and anyone with reduced kidney function. The useful information to bring is the product, the amount on its label and the start date, so that the next HbA1c and creatinine results are read with it in mind. The wider list of medical situations is on creatine and medical conditions.
Sources and dates
- Gualano B et al. Creatine in type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Med Sci Sports Exerc 2011;43(5):770–8. PMID 20881878, abstract read 2026-11-03.
- Gualano B et al. Creatine supplementation does not impair kidney function in type 2 diabetic patients. Eur J Appl Physiol 2011. PMID 20976468, abstract read 2026-11-03.
- Alves CR et al. Creatine-induced glucose uptake in type 2 diabetes: a role for AMPK-α? Amino Acids 2012;43(4):1803–7. PMID 22349765.
- Delpino FM, Figueiredo LM. Does creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis. Clin Nutr ESPEN 2022;47:128–34. PMID 35063192, abstract read 2026-11-03.
- Pinto CL et al. Creatine supplementation and glycemic control: a systematic review. Amino Acids 2016;48(9):2103–29. PMID 27306768.
- Gualano B et al. Effects of creatine supplementation on glucose tolerance and insulin sensitivity in sedentary healthy males undergoing aerobic training. Amino Acids 2008;34(2):245–50. PMID 17396216.
- Newman JE et al. Effect of creatine ingestion on glucose tolerance and insulin sensitivity in men. Med Sci Sports Exerc 2003;35(1):69–74. PMID 12544638.
- Derave W et al. Combined creatine and protein supplementation in conjunction with resistance training promotes muscle GLUT-4 content and glucose tolerance in humans. J Appl Physiol 2003;94(5):1910–6. PMID 12524381.
- Oliveira CLP et al. Creatine supplementation does not promote additional effects on inflammation and insulin resistance in older adults. Clin Nutr ESPEN 2020;38:94–8. PMID 32690185.
- Kreider RB et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 2017;14:18. PMID 28615996.
- PubMed search (creatine[ti] AND diabetes/glucose/glycemic/insulin[ti], trial publication types), run 2026-11-03: 13 records.
- ClinicalTrials.gov API v2, intervention "creatine" × condition "diabetes", run 2026-11-03: 10 records, 4 giving creatine to people with diabetes; NCT06345612 record read the same day.
- FDA CAERS via openFDA (
api.fda.gov/food/event.json), brand name containing "creatine", run 2026-11-03: 210 reports; reaction-term counts as stated.