Diabetes Forecast

Common Cold Remedies

Your guide to over-the-counter medications and diabetes care

By Erika Gebel, PhD , , ,

It's that time of year again. Stuffy noses, scratchy throats, upset tummies, and splitting headaches can send even the most stoic among us to the local drugstore for a magic pill to take away the pain. The fluorescent aisles of brightly colored bottles promising fast relief can seem daunting. Are all over-the-counter cold and flu meds safe for people with diabetes?

Most experts agree that most people with diabetes can feel free to select whatever over-the-counter (OTC) product works best for them, so long as the medication is taken as directed. At the same time, everyone is different so it's important to shop smart to ensure a quick and safe recovery from this season's infections.


Pseudoepinephrine, the decongestant found in OTC products kept behind the pharmacist's counter, and phenylephrine are both related to a hormone in the body called epinephrine. This "fight or flight" hormone opens up air passages, but it also increases blood glucose levels. "Either [decongestant] can aggravate blood glucose," says Jerry Meece, RPh, FACA, CDE, director of clinical services at the Plaza Pharmacy and Wellness Center in Gainesville, Texas. "They tend to drive it up." However, this doesn't happen with everyone, says Keith Campbell, RPh, FASHP, FAPhA, CDE, a professor at Washington State University. "If you are one of the people who is majorly affected by decongestants, you will know when you check your blood [glucose]," says Campbell. Then, he says, people using insulin can adjust their doses to keep blood glucose under control. It may be best, however, to reach for a nasal spray to help clear up congestion without increasing blood glucose.

Cough Syrup

They're syrups, so yes, they are typically full of sugar, but does that mean sugar-free syrup is necessary for people with diabetes? Because people take only a couple of teaspoons of syrup at a time, Meece says that "the sugar in cough syrup isn't likely to affect blood glucose." However, if sugar-free cough syrup isn't overpriced, he sees no downside in using it.

Meter/Monitor Accuracy

There's been concern that certain OTC medications can cause false blood glucose readings. "Ten years ago, as companies were changing the process by which they monitor glucose, several meters used a system that could be impacted by acetaminophen [the pain reliever in Tylenol and other medications], so they worried about that," says Campbell. "I was on a couple of committees to look at that. The amount it changed wasn't clinically significant." So while OTC medications may cause meter measurements to be slightly off, in most people it's not enough to make a significant difference. Makers of continuous glucose monitors warn that acetaminophen may affect the devices' performance. Talk to your doctor if you have questions or concerns about your blood glucose readings.

Test, Test, Test

While you're ill, follow sick-day rules such as testing for ketones, checking blood glucose often, and getting lots of fluids (8 ounces per hour). Campbell says it's important to keep in mind that some medications, such as antihistamines, can increase drowsiness, which may make it more difficult to drink enough fluids or test. Dehydration can drive up blood glucose levels, he says, so he encourages drinking water or sugar-free electrolyte beverages. Campbell also recommends keeping extra testing supplies at home, so that when a sick day comes, you're ready.

Ask the Pharmacist

Don't just wander around the drugstore dazed and confused. "When making these choices, this is a time to utilize a pharmacist," says Meece. "This is what they are trained for." Tell the pharmacist all your symptoms, what other medications you take, and about your diabetes, he says, so he or she can help you make the best choice.

Mind the Dose

"Some people think if some is good, more is better," says Campbell, but with OTC medications, nothing could be further from the truth. He encourages people to read labels and follow dosing instructions. For example, acetaminophen, in high doses, is toxic to the liver. If you're using more than one medication to treat symptoms, cut down on the risk of an overdose by checking the labels to make sure you're not taking acetaminophen or other drugs from multiple sources.


People with diabetes are more susceptible to illness than those without the condition and are encouraged to get an annual flu vaccine as well as the one-time pneumococcal vaccine. Talk to your health care provider to make sure your vaccinations are up to date.


Zinc lozenges may shorten the duration and decrease the severity of the common cold; study results are mixed. But avoid zinc nasal gels, as they can dull your sense of smell.



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