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Diabetes and Safe Medications for Colds and the Flu: OTC Medication Guide

What should I know about safe drugs to take for a cold or flu (influenza) if you have diabetes?

Picture of pills in packets scattered on a table.
Choosing OTC drugs and remedies can be confusing.

Which drugs and medications are safe to take if you have diabetes?

Generally, medications to treat the signs and symptoms of the flu or common cold are safe to take if you have diabetes, for example, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) or acetaminophen (Tylenol and others) can control pain and fever. Usually, over-the-counter (OTC) cold and cough medications are acceptable for people with diabetes. While sugar-free medications are always preferred, the amount of sugar consumed in a single dose of medication (in syrup form) is minimal and unlikely to cause harm.

People with diabetes may misunderstand that they should reduce their medication dosages if an infection (like a cold or flu) has decreased their appetite and they are eating less. However, being sick usually makes someone resistant to insulin and raises glucose levels - even if you are eating less. So, it is important to continue taking your diabetes medication when you are sick and to monitor for urinary or blood ketones.

Lack of physical activity associated with the illness can raise blood sugar levels.

If you are diagnosed with the flu, your doctor or other healthcare professional can prescribe antiviral medications that can help reduce the duration and severity of your illness.

SLIDESHOW

Diabetes: What Raises and Lowers Your Blood Sugar Level? See Slideshow

Why do diabetics have a more difficult time recovering from common colds (upper respiratory tract infections) and the flu?

People with diabetes mellitus (type 1 or type 2) are at risk of complications from other illness. They may be more susceptible of developing common infections like a cold or the flu because diabetes can weaken a person’s immune system. Complications from the flu include secondary bacterial infections, for example, pneumonia, ear infections, sinus infections (sinusitis), and bronchitis.

How often should I check my blood sugar levels if I have diabetes and a cold or the flu?

The U.S. Centers for Disease Control and Prevention (CDC) provides "Sick Day Guidelines" for people with diabetes. These guidelines recommend testing your blood sugar every 2 to 4 hours while you are sick with a cold or flu and tracking the results. You also should monitor and track urinary ketone levels each time you void (pee). Follow your doctor's guidance for additional insulin so long as ketones are detected. If you vomit, then promptly seek medical care at your nearest Urgent Care or Emergency Department.

What can I drink or eat to control my blood sugar levels when I am sick?

If possible, you should continue to follow your meal plan while you are sick. You may have trouble keeping food down or eating enough food. If you are not able to follow your normal eating plan (that includes a type 1 or 2 dabetes diet plan), be sure to drink plenty of fluids. High blood sugars, fever, or poor appetite can cause dehydration, yet the body needs adequate fluid to eliminate excess glucose. If you are not eating, you can drink water or other fluids free of sugar or caffeine whenever your blood sugar is over 150 mg/dL. Consuming 1 ounce per year of age per hour, up to a maximum of 8 ounces of fluid per hour is a good target.

Eating 45-50 grams of carbohydrate every few hours can help maintain stable blood sugar levels while you are sick. It may be easier to tolerate meals such as soup, crackers, gelatin, or other soft foods.

People with diabetes who are sick and display ketones should contact their doctor and consider taking additional fast-acting insulin as 10% of their total daily insulin dose given every 2 hours so long as moderate to large ketones persist in the urine or blood. If moderate to large ketones persist for more than 4 to 6 hours (or do not improve) despite taking extra insulin every two hours, call 911 or go to your nearest Urgent Care or Emergency Department.

QUESTION

Diabetes is defined best as... See Answer

When should I see a doctor if I have diabetes and get a cold or the flu?

According to the "Sick Day Guidelines for People with Diabetes" issued by the CDC, you call your doctor or go the nearest Emergency Room or local Urgent Care Centers if you experience signs and symptoms, for example, you are unable to eat food for more than 6 hours, vomiting, severe diarrhea, loose more than 5 pounds (2.6 kg.), Fever greater than 101 F (37.7 C), blood glucose level over 250 mg/dL on two separate checks, and blood glucose level lower than 70 mg/dL..

Moderate to large amounts of ketones in the urine or blood, difficulty breathing, and feeling confused or unable to think clearly, or feeling sleepy.

How can I help prevent infections?

Getting the yearly seasonal flu vaccine is the best way for people with diabetes to prevent the flu and its complications. Other practices to help prevent colds or the flu include avoiding contact with those who are ill and washing the hands frequently, especially before meals or touching your face.

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Reviewed on 9/4/2019
References
Flu and people with diabetes. CDC. Updated: Sep 18, 2018.
<https://www.cdc.gov/flu/diabetes/index.htm>

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