The Best Cold Medicines for People with Diabetes

Our expert pharmacist advises how to find over-the-counter cold and flu medications that are safe for your diabetes.

Reviewed by Dietitian Christa Brown, M.S., RDN, LD

Searching for relief for your runny nose, sore throat or cough? Many over-the-counter cough, cold and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have heart disease, high blood pressure or diabetes." Unfortunately, your doctor or healthcare practitioner is not along for the trip to the pharmacy to give you the green—or red—light.

Because illness causes your body to release stress hormones that in turn, naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too.

Related: LivingWell with Diabetes

Simple Is Best When It Comes to Choosing Cold Medicine

Keep it simple by choosing an over-the-counter medication based on the types of ingredients proven to relieve your particular symptoms. Often a medication with just one ingredient is all you need to treat your symptoms rather than agents with multiple ingredients.

"To choose the correct medication, take time to speak to a pharmacist," says Jerry Meece, R.Ph., CDE, of Gainesville, Texas, a pharmacist and Certified Diabetes Care and Education Specialist. "The proper remedies may not only make you feel better but also cut the length of the illness and possibly save you a trip to the doctor."

Oral cold and flu pills are often a better choice than syrups with the same ingredients because the pills typically contain no carbohydrates. If you decide to use a syrup, look for one that is sugar-free. If you can't find one, the small amount of sugar in a syrup will likely affect your blood sugar less than the illness itself, says Meece.

Safe OTC Cold Medicines for Diabetes

Many pharmacists recommend these products for people with diabetes based on their symptoms.

Cough

Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine])

Congestion, Mucous in Sinus Passages

Best options: Decongestant pseudoephedrine (Sudafed); phenylephrine; phenylpropalamine

Phlegm, Mucus in Respiratory Tract

Best option: Expectorant guaifenesin (Mucinex, Robitussin)

Pain and/or Fever

Best options: Analgesic acetaminophen (Tylenol); aspirin

For fever and pain relief, look to analgesics, including aspirin and acetaminophen. Both are safe for most people and commonly available. The analgesic class of nonsteroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and naproxen, may increase blood pressure and are not a good choice for people with kidney problems. Note: Be sure to call your healthcare practitioner if your temperature rises above 103 degrees Fahrenheit.

The American Diabetes Association (ADA) cautions that some CGM sensors—including the Dexcom G5, Medtronic Enlite and Guardian—may be impacted by acetaminophen (which includes Tylenol). If you wear a CGM sensor and are taking acetaminophen or a cold medicine containing acetaminophen, the ADA recommends using finger sticks to check your blood sugar levels.

Runny Nose, Itchy Eyes

Best option: Antihistamine

Less-sedating options: Certirizine (Zyrtec); loratadine (Claritin)

More-sedating options: Chlorpheniramine (Chlortrimeton); diphenhydramine (Benadryl)

For a stuffy nose, oral decongestants—including pseudoephedrine, phenylephrine and phenylpropanolamine—can increase both blood glucose and blood pressure and therefore are not usually recommended.

"The occasional use of a decongestant should be the rule," says Robert Busch, M.D., an endocrinologist from Albany, New York. You'll have to sign the pharmacy register for over-the-counter remedies containing pseudoephedrine. Federal law limits pseudoephedrine purchases because the drug can be used to make illegal methamphetamine.

All oral antihistamines are effective for sneezing, runny nose, nasal or eye itching, postnasal discharge, conjunctivitis and allergic rhinitis.

Non-Medicinal Ways to Help Treat a Cold

While you should discuss with your health care provider about whether or not to take medication, there are other things you can do to help speed up your recovery. Start with staying hydrated. For people with diabetes, this means unsweetened beverages, like water and tea. You can make your own herbal tea blends to have on hand for times when illness strikes.

Soup is also hydrating—and comforting. Just make sure it's a diabetes-friendly soup that won't spike your blood sugar levels into an unhealthy range.

Although being sick often means not feeling up to eating, it's important for those with diabetes to maintain stable blood sugar levels. This means making sure you're checking your blood sugar regularly throughout the day and taking appropriate action if your blood sugar levels are too high or too low.

Of course, you also want to be sure you're getting plenty of rest when you're under the weather to give your body the time and resources it needs to heal.

The Bottom Line

While not all cold medications are suitable for people with diabetes, there are several that are still appropriate to use. Choose one with minimal ingredients that target your symptoms. It's also helpful to discuss your options with a pharmacist who can guide you to the safest one.

As a precautionary measure, the ADA recommends an annual flu shot—ideally in September—for people with diabetes. This is because, like a cold virus, the flu virus can also increase your blood glucose levels, which inhibits your body's ability to fight off the virus. And while the vaccine doesn't guarantee you will avoid influenza altogether, it does reduce your risk of illness—and potential complications if you do get it.

Read the original article on Eating Well.