Treating The Common Cold And Type 2 Diabetes
It is that time of year again and as a Pharmacist/Certified Diabetes Educator one of the most common questions over the fall, the holiday’s and winter months is “What do you have to treat my cold?” or simply “Can you make me feel better?” Well there is no cure and we cannot wave our “therapeutic” wand and make symptoms disappear but there are a variety of products to help with the symptoms of cough and cold. If the patient is relatively healthy it may be a bit of a hit or miss scenario but usually the product will ease the symptoms until the cold runs its course over 7 to 10 days. The picture becomes less clear when the patient is taking other medications, has medical conditions such as kidney disease, blood pressure, or they have diabetes. Assisting our patient choose an appropriate product that will not worsen their existing medical conditions, and lessen the symptoms that make them feel miserable is key. Diabetes is a condition that requires some adjusting to choose the right product. It is not always a “Sugar free”, “Natural”, or alternative product that is best, as active ingredients may have issues. These include raising blood sugars, raising blood pressure or stressing the kidneys (common issues with diabetes). Usually after a brief discussion to educate the patient, a product can be chosen to help both their symptoms and minimally impact their diabetes and blood sugars. The discussion that follows is a practical approach on how to decide what a person with diabetes can use so that they understand why we avoid certain classes of products due to a their existing medical conditions. Blood Sugars Can Rise when Ill It is important to realize that when a person with diabetes is “fighting” a cold it produces stresses on the body as a whole and Continue reading >>
Cough, Cold, Congestion…and Diabetes?
This article is for informational purposes only. Please consult with your MD before taking any cough and cold medications! During cough and cold season, the cold remedy aisle at the local supermarket or pharmacy is packed with people looking for a fix for their coughing, sneezing, sniffling and aching due to the common cold, virus, or flu. Sales of cough and cold syrup and cough drops soar. Tis the season to buy tissues! Be advised that many cough/cold syrups are made palatable by adding some form of sugar or carbohydrate. For those with Met A, the inclusion of carb has no great significance and allows the “spoonful of medicine” to go down. For those with Met B, this hidden carbohydrate can have major consequences regarding insulin release, fat gain, blood sugar readings, cravings…and all the symptoms of uncontrolled Met B. Liquid DayQuil and NyQuil contain significant carbs. A 2 Tbls dose contains 19 grams of carbohydrate! And that 19 grams of carbohydrate comes straight from pure sugar used to make the cough syrup taste more palatable. As we know, just being “under the weather” with a cough, cold, or flu causes blood sugar and insulin release to rise. If you are feeling sick for a few days, it is a great idea to temporarily retreat to Step 1. The rise in stress hormones caused by illness/healing automatically causes a rise in blood sugar, insulin release, and fat gain…cravings, too! Step 1 is a great safety net. If it’s just a mild cough, a slight runny nose….no problem. But if you are coughing, sneezing, head is aching, nose is running, joints are aching….you should consider a spoonful of Step 1. So, what to do about cough/cold medicines? Opt for the capsules or caplets! I think we feel that the “cough syrup” is more effective but, except for th Continue reading >>
Cold Medicines That Are Safe For Diabetes
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, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Simple Is Best for Cold Medicines 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. "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 may contain no carbohydrate. 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, Meece says. Safe OTC Cold Medicines Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes. Symptom: Cough Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine]) Sympt Continue reading >>
A Common Over-the-counter Cough Suppressant Can Boost Insulin
Dextromethorphan (DXM) is a cough suppressant found in Vick's NyQuil Cold & Flu Relief, Triaminic Multi-Symptom Fever, Dimetapp Children's Multi-Symptom Cold & Flu, Tylenol Cold Multi-Symptom Nighttime, and similar over-the-counter cold medicines that make life so much more bearable when you're coughing your lungs out. It's not good for everyone though; the American Academy of Pediatricians has recommended that it not be given to children under the age of four, because it is completely ineffective for them and may even cause them harm. But although it may be bad for kids, it may be good for type 2 diabetics; a recent report in Nature Medicine suggests that it increases glucose tolerance and does so in a way that is more effective than existing drugs. Antidiabetic drugs currently on the market increase what's called the basal levels of insulin secretion—it goes up all the time, whether it's needed or not. This basal insulin secretion is a major cause of lethal hypoglycemia in the patients who take these drugs. New types of drugs that only boost insulin in response to glucose are thus highly desirable. To do that, we need to be able to manipulate the pancreas. It's a somewhat unusual organ; many neural receptors are also found in pancreatic islet cells and, as of now, we don't really know what we are doing there. So some researchers in Europe decided they might be the key to tweaking the pancreas' activity. In the brain, NMDA receptors are the ones targeted by DXM. To see what NMDA receptors are doing in pancreatic islet cells, these researchers took the tried and true approach of eliminating them and seeing what happened. The researchers removed the receptors genetically by knocking them out in mice. They also removed them pharmacologically, by treating mice with DXM a Continue reading >>
Are Over-the-counter Cold Remedies Safe For People Who Have High Blood Pressure?
Over-the-counter cold remedies aren't off-limits if you have high blood pressure, but it's important to make careful choices. Among over-the-counter cold remedies, decongestants cause the most concern for people who have high blood pressure. Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels as well, which can increase blood pressure. To keep your blood pressure in check, avoid over-the-counter decongestants and multisymptom cold remedies that contain decongestants — such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline. Instead: Choose a cold medication designed for people who have high blood pressure. Some cold medications, such as Coricidin HBP, don't contain decongestants. However, these medications may contain other powerful drugs, such as dextromethorphan, that can be dangerous if you take too much. Follow the dosing instructions carefully. Take a pain reliever. To relieve a fever, sore throat or headache or body aches, try aspirin or acetaminophen (Tylenol, others). Use saline nasal spray. To relieve nasal congestion, try saline nasal spray. The spray can help flush your sinuses. Soothe your throat. To relieve a sore or scratchy throat, gargle with warm salt water or drink warm water with lemon juice and honey. Drink plenty of fluids. Water, juice, tea and soup can help clear your lungs of phlegm and mucus. Increase the humidity in your home. Use a cool-mist humidifier or vaporizer to moisten the air, which may ease congestion and coughing. Get plenty of rest. If you're not feeling well, take it easy. Call your doctor if your signs and symptoms get worse instead of better or last more than 10 days. Continue reading >>
How Medications Can Impact Type 1 Diabetes Management
When taking medicine, you must always read labeling carefully and be aware of possible side effects. When you have Type 1, you have the added consideration of how it will affect your blood glucose levels as well as any devices that you depend on for your diabetes management. And as with anything you digest, you must know the carb count, administering insulin as needed. Apart from daily medication such as birth control, having a sick-day protocal is always smart for the unexpected bug. This way, you’ll be stocked ahead of time with essentials to ease your mind and decrease additional stress over your care. Here are some must-knows about over-the-counter medication and what it means for your Type 1. Cold Medicine Being sick stresses the body, and when your body’s stressed it releases blood-glucose raising hormones. These hormones can even prevent insulin from properly lowering your levels. Consider the following when taking cold medicine: Opt for pill forms – if possible, pills over syrups are better for their lack of carbohydrates. Check for added sugars – When taking syrups, double-check the labels of over-the-counter brands to make sure they don’t have added sugar. See if there’s a sugar-free option – Though small doses of sugar don’t pose a huge risk, your safest bet is to ask your pharmacist about sugar-free syrups. Check your BGLs frequently – This should be triple the time you typically check. Being sick makes you more susceptible to BGL extremes. Administer insulin accordingly – Medicine, just like food, must be dosed for. Blood Glucose Levels Even without sugar, short-term cold medicines can send your blood glucose levels spinning. Aspirin has been known to lower glucose levels Pseudoepinephrine, the decongestant found in most over-the-counter Continue reading >>
Managing Diabetes With A Cold Or Flu
The cold and flu season is on its way. And while sick days bring everyone down, people with type 2 diabetes have some special considerations when they're under the weather. In addition to choosing the right cold medications and checking in with your doctor about possible dosage changes, good diabetes care means being prepared for the days when you would rather not drag yourself out of bed for a glucose check or a snack. Pick the Right Cold Medicine “A lot of [cold and flu] medications, particularly cough syrup, are high in glucose,” says internist Danny Sam, MD, the program director of the residency program at Kaiser Permanente in Santa Clara, Calif. His practice specializes in adult diabetes. If you have diabetes, your best bet is a medicine that is clearly labeled sugar-free. Almost every major pharmacy has a store brand of sugar-free cold or cough medicine, says Dr. Sam. If you have questions, ask your pharmacist for help. Check Blood Sugar Often “Diabetes is not as well controlled when you are sick,” observes Sam. This is because when your body fights infection, it releases a chemical cascade that can alter your body’s glucose and insulin response. As a result, you may need to check your blood sugar more often than you usually do. People with type 2 diabetes may need to check their blood sugar four times a day, and should check their urine for ketones anytime their blood sugar level is higher than 300 mg/dL. Other medications you may need to take when you are sick can affect your blood sugar levels: Aspirin may lower blood sugar levels Certain antibiotics may decrease blood sugar levels in those taking some oral diabetes medications Decongestants may raise blood sugar levels Adjust Your Plan “You have to monitor your blood sugar more frequently and you m Continue reading >>
Sleeping Aids And Diabetes
People with diabetes certainly aren't immune to issues with insomnia or other sleeping problems that occur with age, jet lag or seasonal affective disorder. When that happens, sometimes counting sheep just doesn't cut it. But there has been concern discussed recently in the D-OC about using sleep aids with diabetes. A thread on TuDiabetes starts off with the notion that "any kind of sleep aid is taboo for an insulin-dependent diabetic." So we decided to put on our Mythbusters hat and investigate whether this claim is true or false... Although there aren't any recommended sleep aids specifically for people with diabetes, Kelley Champ Crumpler, a diabetes nurse educator and the wife of an endocrinologist, primarily recommends melatonin to treat sleeping problems. Melatonin is a naturally occurring hormone in your system that helps to control your sleep and wake cycles. Unlike insulin, melatonin is a hormone that is synthetically made and can be ingested, so a natural supplement is available over-the-counter (usually found in the vitamin section of your grocery store). "We have them start with a small, 1 mg tablet before bed, and can taper up as needed," Kelley says. "Melatonin won't render you useless like other sleep aid/hypnotics will. It's even safe for children to use." If that doesn't work, Kelley says that using an antihistamine that contains either diphenhydramine (found in Benadryl or nighttime pain relievers like Tylenol PM or Advil PM) or doxyalimine (found in the over-the-counter sleep-aid tablets Unisom). Anecdotal evidence on some of the diabetes forums shows that melatonin and antihistamines are the most popular way of treating insomnia. These meds are also "light" enough that they won't knock you out so much that you won't wake up naturally in an emergency Continue reading >>
Are Cough And Cold Products Safe For People With Diabetes?
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? 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, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. 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 smartly to ensure a quick and safe recovery from this season's infections. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. 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…This is what they are trained for…Tell the pharmacist all your symptoms, what other medicines you are taking,” says Jerry Meece, RPh, FACA, CDE, director of clinical services at the Plaza Pharmacy and Wellness Center in Gainesville, Texas." 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 mon Continue reading >>
Drugs That Can Raise Bg
By the dLife Editors Some medicines that are used for treating other medical conditions can cause elevated blood sugar in people with diabetes. You may need to monitor your blood glucose more closely if you take one of the medicines listed below. It’s important to note that just because a medicine has the possibility of raising blood sugar, it does not mean the medicine is unsafe for a person with diabetes. For instance, many people with type 2 diabetes need to take a diuretic and a statin to lower blood pressure and cholesterol. In these and many other cases, the pros will almost always outweigh the cons. Don’t ever take matters of medication into your own hands. Discuss any concerns you have with your healthcare provider. Certain Antibiotics Of all the different antibiotics, the ones known as quinolones are the only ones that may affect blood glucose. They are prescribed for certain types of infection. Levofloxacin (Levaquin) Ofloxacin (Floxin) Moxifloxacin (Avelox) Ciprofloxacin (Cipro, Cipro XR, Proquin XR) Gemifloxacin (Factive) Second Generation Antipsychotics These medicines are used for a variety of mental health conditions. There is a strong association between these medicines and elevated blood sugar, and frequent monitoring is recommended. Clozapine (Clozaril) Olanzapine (Zyprexa) Paliperidone (Invega) Quietiapine (Seroquel, Seroquel XR) Risperidone (Risperdal) Aripiprazole (Abilify) Ziprasidone (Geodon) Iloperidone (Fanapt) Lurasidone (Latuda) Pemavanserin (Nuplazid) Asenapine (Saphris) Beta Blockers Beta blockers are used to treat high blood pressure and certain heart conditions. Not all available beta blockers have been shown to cause high blood sugar. Atenolol Metoprolol Propranolol Corticosteroids Corticosteroids are used to treat conditions where th Continue reading >>
Stress, Inflammation, Diabetes
I like it when studies confirm what I’ve been saying for years, especially when most people didn’t believe me. For years, I’ve been reporting that stress is a major cause of overweight and Type 2 diabetes. And people have scoffed. “It’s just how much you eat and how much you burn off with exercise,” they’ll say. “Stress might lead you to eat more, but that’s the only connection.” Even Richard Bernstein, the low-carb guru and author of Dr. Bernstein’s Diabetes Solution doesn’t get this, although he is right about so many diabetes-related things. He says stress doesn’t raise people’s blood sugar. Well, maybe not immediately. But stress does increase insulin resistance and promote abdominal fat. So in the long run, stress will tend to make you fat, and raise your blood glucose, your cholesterol and your blood pressure significantly. This has been shown for years — for example in this 1999 English study of 10,000 civil servants. Those with high work stress had twice the rates of obesity, heart disease, diabetes, and some neurological problems as those with low stress. But what is stress exactly, and what can we do about its effects? Stress and Inflammation Stress is anything that causes our bodies to feel threatened. Stresses can be emotional, economic, or physical. Physical stress can include things like cold and fatigue, and a recent study (reported on in Diabetes Flashpoints) showed that breathing polluted air caused insulin resistance in mice. Now, how could breathing dirty air make a mouse (or a person) fat or diabetic? Experts like Janice Kiecolt-Glaser, PhD, say the link is that stress causes inflammation. When under stress, our bodies release chemicals called “pro-inflammatory cytokines,” which are good for fighting short-term infec Continue reading >>