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[IP] some does and donts for diabetes and meds
Prepared By: Susan Jin, BScPhm, CDE
Page 1 of
4 General Nutrition Pharmacy
372-8GNP (372-8467)Date: January 17, 2000
SOME DO'S AND DON'TS OFOVER-THE-COUNTER AND HERBAL SUPPLEMENTSFOR PEOPLE WITH
DIABETES COUGH AND COLD
Remember non-pharmacological support such as humidifiers, gargling with salt
water, increase fluids and rest
Sore throats: sugar-free lozenges (Fisherman's Friend, Bentasil, Cepastat,
Zinc lozenges with or without Echinacea)
Dry cough: sugar- and alcohol-free cough syrups (Benylin DM, Buckley's DM,
Wet cough: sugar- and alcohol-free preparations (Benylin DM-E, Benylin E,
Vitamin C 500mg twice daily. (This is a conservative approach, many people
will mega-dose Vitamin C). Short-term use is safe (until cold symptoms
resolve, less than 1 month)
Echinacea 1000mg three times daily may help, especially if started early.
Short-term use is safe (until cold symptoms resolve, less than 1 month)
Decongestants increase blood sugars, blood pressure and affects thyroid. Use
decongestants only under the advice of a physician and only when
"desperately" needed. Examples of products containing decongestants are
Dimetapp, Entex LA, Benylin - any formulation with "D", Sinutab, Sudafed,
Advil Cold and Sinus, Drixoral, and Tylenol Sinus. If desperate, topical
decongestants are preferred for limited use (less than 5 days). Examples of
topical decongestants are Otrivin and Dristan nasal spray. Topical
decongestants can cause rebound congestion on long-term use. STOMACH RELIEF
Pepcid AC, Zantac 75 or house brands are fine. Check with your doctor or
pharmacist if any doubt as to the problem. Heartburn can resemble a heart
Many antacids are high in sodium, which increases blood pressure. Avoid
Riopan and Gaviscon. Eno has ASA in it, which can interact with many
prescription medications as well as increase the risk of a stomach ulcer.
Many chewable tablets contain sugar (1 = 10 Tums Regular, 8 Extra
Strength, or 4 Ultra Strength; 1 = 12.5 Rolaids Regular or 14.5 Extra)
Pure allergy formulations, both the drowsy (Benadryl and Chlortripolon and
non-drowsy (Allegra, Claritin, and Reactine) are safe and effective
Echinacea may help to boost the immune system to fight the allergy symptoms
Be careful to avoid "allergy and sinus" remedies such as Allegra D, Claritin
Extra, and Reactine Plus. The "D", "Extra" and "Plus" are decongestants
which should be avoided as stated above in "cough and cold". PAIN RELIEFDO:
Acetaminophen as needed (example: Tylenol) DON'T:
Aspirin can increase blood pressure, especially if you are taking a diuretic
and blood sugar, particularly if you are taking a sulfonylurea (such as
glyburide or diamicron) CONSTIPATIONDO:
Try to identify and treat (if possible) the reason for the constipation. For
example, some prescription medications can cause constipation (codeine
Increase your fluid intake to at least 6 to 8 cups per day (i.e. water or
Use sugar-free formulations such as Metamucil sugar-free or the sugar-free
house brand. FOOT CAREDO:
See a physician or foot care specialist for a proper diagnosis of any foot
Regularly inspect your feet and consult a foot care provider if possible
HERBS/VITAMINS The following is provided as information only and is not
intended to suggest that all people with Diabetes should be taking the
following herbs. Please discuss with your doctor, pharmacist or diabetes
educator before changing your supplement intake. Fibre
High-fibre diets have been associated with lower-fasting blood sugar levels
and lower insulin requirements.
May increase insulin sensitivity.
Aim for 25 to 35gm per day (See a Registered Dietitian for details).
Chromium 400-600mcg daily
May increase insulin activity by increasing tissue receptor sensitivity.
Some studies suggest it is helpful only if a chromium deficiency exists
(chromium deficiency is rare).
Shown to significantly reduce serum triglyceride levels (triglycerides are
one type of blood fat). Vitamin B Complex 100mg daily
Plays a role in the metabolism of protein and carbohydrates.
Vitamin B6 deficiency has been shown to reduce pancreatic and circulating
insulin levels and may be associated with abnormal glucose tolerance.
Potential benefit in people with diabetic neuropathy as Vitamin B may help in
neuritis. Vitamin E 200-800IU daily
Antioxidant may reduce the risk of atherosclerosis and improve metabolic
control in insulin responsiveness.
If you are on anticoagulant drugs and take vitamin E supplements, check with
your doctor. Vitamin C 250 to 500mg daily
Vitamin C is an antioxidant that may protect against oxidative damage of
LDL-cholesterol and thereby reduce the risk of diabetes-related
May assist in the regulation of blood sugar and insulin levels through its
effect on the inhibition of insulin release.
Can interfere with urinary glucose testing (rarely used today) and some blood
glucose monitors at high doses (=2000mg daily). Check with your pharmacist
to determine which glucose meters are affected. Magnesium 250 to 350mg daily
Involved in glucose metabolism and the production and release of insulin.
Supplementation with magnesium may help to prevent diabetes-related
retinopathy and ischemic heart disease.
POSSIBLE INTERACTIONS WITH HERBS May lower blood glucose May increase
Garlic Ma Huang
Ginger Licorice (via reducing Potassium)
These may affect blood sugar control:
Nettle DRUG INTERACTIONS Pills that LOWER the blood sugar:
Blood thinners (Coumadin)
B-blockers (atenolol, metoprolol, propanolol)
Anti-inflammatory drugs (ibuprofen, indomethacin, diclofenac, ketoprofen)
Pills that RAISE the blood sugar:
Diuretics (furosemide, hydrochlorothiazide, Diazide, amiloride)
Birth control pills
Hormones -- estrogen (CES, Premarin), progesterone (medroxyprogesterone)
Remember to always take your medications as prescribed by your Doctor. Don't
change your therapy without first discussing with your diabetes-team. Many
of the above listed interactions are controlled on an individual basis.
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earth and read the books we didnt have a chance to read in our past lives!
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