When taken as recommended, dietary supplements containing gymnema are not associated with significant adverse side effects. It is best to take Gymnema Sylvestre with food, as mild gastrointestinal upset may occur if gymnema is taken on an empty stomach. Extremely high doses may have the potential to induce hypoglycemia (abnormally low blood sugar) in individuals who are prone to hypoglycemic episodes. In those individuals with active diabetes, it is recommended to consult your personal physician before and during use of gymnema, as alterations to your dosage of insulin or other anti-diabetic medications may be warranted.