Before using any over the counter medication, diabetics should first discuss with their doctor whether the medication is safe and appropriate.
A common medication used for runny noses is a decongestant. Decongestants are available either as a pill or as a nasal spray. Common decongestants found in pill form include pseudoephedrine and phenylephrine. Both of these ingredients may raise blood glucose and blood pressure levels. People with diabetes should only use decongestants cautiously and under the direction of a doctor. Because of its misuse and side effects, pseudoephedrine is found behind the pharmacy counter. This measure means that pharmacists can make sure that pseudoephedrine is being used appropriately. Phenylephrine may be found on the store shelves.
Remember that many cold medications contain multiple ingredients. Be sure to read carefully all the ingredients in a preparation. Many cold preparations contain non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil) or naproxen (Aleve). These agents can be harmful to the kidneys of diabetics and, if pain is not an issue, may not be needed. Therefore, buying separate ingredients rather than a combination medication may be safer.
A nasal decongestant works more quickly than a decongestant taken by mouth. This preparation is sprayed into each nostril. Nasal decongestants usually do not have a significant effect on blood glucose or blood pressure levels because their effect is mainly local. However, if used excessively, they can have effects on glucose and blood pressure. The important downside to nasal decongestants is a possible rebound effect that makes your nose even more congested if you use them for more than 3 to 5 days. For that reason, they are best for short-lived colds and not for persistent allergies.
Saline nasal sprays are safe for diabetics and do no affect blood glucose levels. Nasal strips are another good option and are available over the counter. The strips work by mechanically opening the nostrils.
Antihistamines are a commonly used for a runny nose. Antihistamines can help dry a runny nose due to an allergy, but are not helpful for a runny nose due to the common cold. Antihistamines do not raise blood glucose levels and are usually safe for diabetics. However, some of the older over-the counter antihistamines cause sleepiness. This can be a real problem in diabetics, especially when combined with sedatives or alcohol. Diphenhydramine (Benadryl) is an antihistamine that causes sleepiness, but fexofenadine (Allegra), loratadine (Claritin) and cetirizine (Zyrtec) are less sedating.
The most important step, though, in treating your symptoms is to be sure you have the correct diagnosis. Go over your symptoms and signs with your doctor. Many times, what seems to be an allergy may in fact be a bacterial sinus infection. Bacterial sinus infections are common in diabetics and need to be treated with antibiotics, which are only available by prescription. So don’t rush out and buy an over-the-counter preparation without first talking with your provider.
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