The symptoms of a common cold or the flu, such as nasal congestion, often prompt the use of over-the-counter (OTC) cold and flu medications. For individuals managing diabetes, selecting these products requires careful consideration because many standard ingredients can interfere with blood glucose control. The body’s stress response to illness already tends to raise blood sugar levels, and certain decongestant ingredients can compound this effect.
Decongestant Ingredients That Affect Blood Sugar
The active ingredients found in oral decongestants, primarily pseudoephedrine and phenylephrine, pose the greatest risk to blood sugar regulation. These sympathomimetic medications stimulate the sympathetic nervous system, which narrows blood vessels in the nasal passages to reduce congestion. However, this systemic effect can disrupt glucose metabolism, causing an increase in blood glucose levels and potentially interfering with insulin effectiveness. These systemic decongestants also carry a risk of increasing blood pressure, which is a dual concern since many people with diabetes also manage hypertension. It is therefore generally recommended that people with diabetes avoid these oral decongestants or use them only under the guidance of a healthcare provider, and they must check the active ingredients on OTC combination products.
Safe Localized Options for Congestion Relief
Localized treatments offer an effective alternative for congestion relief without the systemic risks of oral decongestants. The safest option is a simple nasal saline spray or rinse, which moistens the nasal passages and thins the mucus without impacting blood glucose or blood pressure. Another localized option is a topical decongestant spray containing oxymetazoline or xylometazoline. Since these are applied directly, they are absorbed in much smaller amounts than oral forms, minimizing the effect on blood sugar; however, they should not be used for more than three days to avoid rebound congestion. For accompanying symptoms like pain or fever, acetaminophen is a generally safe choice, and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can also be used, though individuals with kidney issues or high blood pressure should approach them with caution.
Non-Medication Strategies for Symptom Management
Simple, non-pharmacological methods provide substantial relief from congestion and are always safe for blood sugar management. Maintaining adequate hydration is particularly important during illness, as high blood glucose levels can increase fluid loss; drinking plenty of water or clear broth helps thin mucus secretions. Using a humidifier or spending time in a steamy bathroom can soothe irritated nasal passages and loosen congestion, as the warm, moist air helps rehydrate mucous membranes. When lying down, elevating the head with extra pillows promotes drainage and reduces post-nasal drip. For a sore throat or cough, use sugar-free throat lozenges or choose sugar-free alternatives to cough syrups to avoid unexpected glucose spikes.
Monitoring Blood Sugar During Illness
Illness, even a minor cold, stresses the body and triggers the release of hormones that naturally counteract insulin, making blood sugar control more difficult. Increased frequency of blood glucose testing is necessary during any sickness to catch and manage potential highs or lows. Individuals should continue taking their prescribed diabetes medications, including insulin and oral agents, unless a healthcare provider advises a change in dosage. Having a set of “sick day rules” prepared with a doctor is helpful, outlining when and how to adjust medications based on blood sugar readings. Contact a healthcare provider immediately if blood sugar remains excessively high, if there is persistent vomiting or diarrhea, or if a fever exceeds 101°F.