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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  
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, 
Koffex 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 
attack.  DON'T:
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 
caffeine-free beverages) 
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 
care problems. 
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 
blood glucose   
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:
Corticosteroids (prednisone) 
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.

we should believe in reincarnation, it ll give us a chance to come back to 
earth and read the books we didnt have a chance to read in our past lives!
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