Used at the amounts suggested, gymnema is generally safe and devoid of side effects. However, there is one case report of toxic hepatitis, possibly due to the use of gymnema.¹⁸ The safety of gymnema during pregnancy and breast-feeding has not yet been determined. People with diabetes should only use gymnema to lower blood sugar under the clinical supervision of a healthcare professional. Gymnema cannot be used in place of insulin to control blood sugar by people with either type 1 or type 2 diabetes.