Spring is fast approaching and we are beginning to enjoy more hours of daylight. For some of us, spring might be the time when we come down with a cough and cold. Let’s hope we avoid this cold season but if we don’t I would like to share some pearls about over-the-counter medications (OTC) that you might want to try to alleviate your symptoms.
According to Wikipedia, “a common cold is described as a viral infectious disease of the upper respiratory tract that primarily affects the nose. The throat, sinuses and larynx could also be affected. Signs and symptoms might include coughing, sore throat, runny nose, sneezing, headache and fever. People usually recover in 7-10 days but it could be longer. A cold can lead to pneumonia especially if you suffer from other health problems.” Since the cold is caused by a virus, antibiotics are not going to be useful and symptomatic therapies such as OTC medications are often purchased. However, those of us with diabetes must be more cautious in choosing OTC products and this is what I will concentrate on for the rest of this blog.
An over-the-counter (OTC) medication is a medicine sold directly to a consumer without a prescription from a health care professional. The sale of OTC’s is a big business and their sale is regulated by government agencies to make sure these products are safe for the consumer to use.
OTC medications can have negative effects if they are not used according to the package and pharmacist recommendations. The three most common OTC medications purchased are those to treat a stuffy nose, stop sneezing, stop post-nasal drip, cough syrups/lozenges and analgesic medications to treat the headache, aches and pain. I will write a separate blog on the pain relieving/analgesics medications. Keep in mind the sick-day management guidelines as discussed in the first blog on Diabetes and the Flu posted February 14th, 2020.
COUGH AND COLD
The majority of these products try to treat multiple symptoms in the same tablet/capsule/syrup. The directions might say to take 2 tablets such that you get an effective dose of the medication. An antihistamine is the ingredient that helps prevent the sneezing, sniffles and post-nasal drip. It helps to dry up the nasal secretions. This ingredient has minimal effect, if any, on diabetes management. It could cause you to be a bit drowsy so be careful with taking on tasks that could be hazardous and require your full alertness.
Decongestants are the ingredients that shrink the swollen membranes of the nose and help you to breath easier. Decongestants are used in nasal sprays for topical use as well as oral medications. The topically applied nasal sprays act faster than the oral agent. They could provide relief for up to 10-12 hours if they don’t get washed away by nasal secretions. Usually these products have only the one ingredient. Adverse effects are not common since the absorption from the nasal membrane tends to be low. It is important not to use these products for greater than 5-7 days since a rebound congestion can occur which means that the product you used to clear your congestion is now causing the congestion.
Oral decongestants should be chosen wisely. This group of medicines can have negative effects on heart disease such as an increase in blood pressure, blood sugar changes, and maybe some confusion or anxiety/being anxious. Use should be limited to three to four days especially in Type 1 Diabetes since they can elevate blood sugar values. Keep in mind that when you are not feeling well, your blood sugar could be already increased and if you add a decongestant this might aggravate the sugars even more. Test, test and more testing of blood sugar values is definitely warranted. If your sugars are in good control, you may notice no problems but still increase the frequency of monitoring. My experience has been that I am good for 3 or 4 days of use then I notice an increase in my sugar values. Some products are long acting and some short acting and this may help you to decide which one you prefer to use. Ask your health-care providers for advice on the best product for your health.
Syrups and lozenges for coughs and sore throat can be chosen as a single or multiple ingredient product. If you are already using a multi ingredient product for your other symptoms, it is wise to choose a single agent product for the cough & throat symptoms. More is not always better. Most cough medicines are in a syrup base which means it contains some format/type of a sweetener.
A cough suppressant helps to relieve a cough by blocking the cough reflex. They are indicated for use when you are experiencing a dry hacking cough. A cough expectorant helps to thin the mucus and loosen it helping you to clear the airways.
Syrups and lozenges will have some calories so you may need to include this in your daily carbohydrate (CHO) and calorie count. Many of the products now are sweetened with artificial/natural sweeteners but depending on which one is used, they too could affect diabetes management. Always check the alcohol content of a product as this too adds calories or if you take too much of the product it could interfere with medications you may be taking for other illnesses.
In summation, most of the cough and cold treatment products are safe for at least short-term use in diabetes. It is our responsibility to read the label, ask for advice, take the product as directed and test our blood sugar values often and monitor how we are feeling. If you feel you have reacted to any product/ingredient in an unfavourable manner, let your health care providers know so they can add it to your history and avoid it in future treatment plans.
Non-pharmacological options include: good hand-washing, avoiding people with colds/wear a mask, rest, healthy eating and exercise can all contribute to well-being.
Over the years you may have seen or heard discussions for and against the health benefits of these OTC medications in treating symptoms of a cold, so please consult with a pharmacist before you make any purchase.
Please note that for parents of children with or without diabetes, I recommend that your always consult with your health care provider(s) before using any product since some of the above-mentioned categories of drugs are not recommended in the younger population.
No doubt you have heard some “Old Wives’Tales” or myths about the cold and flu season and I would like to help clarify a few for you (reference CTV News, October 2019 accessed on the web February 23rd,2020):
1)Cold weather can make you sick- people tend to gather more inside during the cold weather and close proximity to someone who is sick might be more likely, but the COLD temperature does not make you sick: a virus does.
2)Antibiotics can help combat a cold or flu- antibiotics are effective only against bacterial infections and the cold is a viral infection. Taking antibiotics could do more harm than good and also increase the chance of antibiotic resistance.
3)Vitamin C is effective for combatting a cold- studies on Vitamin C have been inconsistent and more research is needed.
Thank you for your time and interest in my blog. Don’t forget to subscribe and make your comments known to me.
I will be discussing the use of OTC analgesic/pain relieving medications in my next blog in 2 weeks so stay tuned. I will be posting my blogs on Saturday's.
References:
1)Wikepedia
2)Taylor,Jeff. Over-the-Counter Medicines and Diabetes Care: Can J Diabetes.2017 Dec;41(6):551-557
3)https://www.verywellhealth.com/cold-and-flu-season-and-diabetes accessed 21/02/2020
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