Some common over the counter (OTC) cold medications can make diabetes harder to manage.
Certain cold medications can raise or lower your blood glucose. Some medications can also interfere with continuous glucose monitors (CGMs).
If you have diabetes, it’s important to have a plan of action in place if you catch a cold. This will help you know what to do and how to recover faster.
How does illness affect your blood sugar? When you’re sick, it can be hard to keep your blood sugar in the normal range. The stress of illness can trigger the release of hormones that cause your blood sugar levels to rise. And sometimes, illness can cause a lack of appetite and your blood glucose levels may plummet. It can be a delicate balancing act to manage your blood sugar when you’re sick, even if you’re taking your diabetes medications as prescribed.
If you do get sick, it’s important to check your blood glucose readings frequently (at least 4 times a day). If readings are consistently higher than 250 mg/dL, you need to check your urine ketone levels and let your healthcare provider know. High glucose and urine ketones can be a sign of a serious complication called diabetic ketoacidosis (DKA).This is when your blood sugar levels become dangerously high. It can cause problems ranging from dehydration to kidney failure and even coma and death.
Illnesses like a cold or the flu are an important—but preventable—cause of DKA. If you are fighting an illness, your provider will help you adjust your diabetes medications so that you can avoid DKA.
If you have diabetes and catch a cold, some of the medications used to treat it can make your diabetes harder to manage. Some over the counter (OTC) cold medications can affect your blood glucose level, making it harder to keep in the normal range. Also, the infection itself can cause your blood-sugar levels to go up.
If you’re living with diabetes, it’s important to have a plan of action before catching a cold. Let’s take a closer look at what cold medications are safe for you to take to feel better and reduce your symptoms.
What medication can you take for a cough with diabetes? If you have diabetes, you will want to look for cough medications without added sugar or alcohol. The two main ingredients in OTC cough medications to look for are Guaifenesin, which loosens mucus and/or Dextromethorphan, which quiets your cough. You can use these medications separately, or you can find them combined.
Some common combination cough medications for people with diabetes include:
Robitussin Sugar-Free
Diabetic Tussin
Safetussin
Scot-Tussin
Which cold medications should you avoid if you have diabetes? You may want to avoid certain cold medication ingredients when you have diabetes. Let’s take a closer look at cold medications that may impact your blood sugars.
Cough syrups: A lot of cough syrups have added ingredients that can make diabetes harder to manage. Be sure to check the label of your cough syrup for ingredients like sugar, corn syrup, honey, and/or alcohol. If you must take a cough syrup with added sugar, make sure to take the extra carbohydrates into account for your meals or when deciding how much diabetes medication you need to take.
Decongestants: Pseudoephedrine (Sudafed) is a common OTC decongestant, but it may raise your blood glucoselevels. Most nasal decongestant sprays—like oxymetazoline (Afrin)—also carry a warning for people with diabetes. If you do use them, make sure you keep track of your blood glucose readings. That way you can adjust your medications as needed.
Pain and fever reducers: Acetaminophen (Tylenol) and salicylic acid (aspirin) can both interact with certain CGMs to cause abnormal readings. Taking acetaminophen when you have a cold may cause your CGM to have a false high reading. Meanwhile, aspirin may cause your glucose level to appear low.
You may need to check your blood sugar with a glucometer (finger prick) rather than a CGM if you decide to use aspirin or acetaminophen for your cold symptoms. You’ll also want to check the labels of OTC cold medications, as these medications are often found in them.
When should you visit your doctor if you have diabetes and a cold?
If you have diabetes and a cold and your symptoms aren’t improving, you should let your provider know. Seek medical care right away if you:
- Have trouble breathing.
- Have urine ketones.
- Are unable to keep fluids down.
- Lose more than 5 pounds while sick.
- Can’t keep food down for more than 24 hours.
- Have a temperature over 101°F for more than 24 hours.
- Are confused.
- Have a glucose level lower than 60 mg/dL.
The bottom line is that colds are normally not very serious. But some cold medications can make diabetes harder to manage. Some cold medications can raise your blood sugar or make your glucose readings inaccurate. Always read the labels and check the ingredients on any cold medication you take when you have diabetes.
Fortunately, taking care of a cold with diabetes doesn’t have to be complicated. Have a plan for sick days ahead of time so you’ll know what medications you can take and which ones you should avoid.
Excerpted from an article by Frank Schwalbe, MD and reviewed by Karla Robinson, MD, published Sept., 2023
Sources: https://www.goodrx.com/conditions/diabetes/cold-medicine;
References: American Diabetes Association. (n.d.). Preparing for sick days.
Centers for Disease Control and Prevention. (2022). Managing sick days.
