How to Treat Cold and Flu Symptoms If You Have Diabetes

Which medications to take and which to avoid

People with diabetes are at increased risk of being infected with the cold or flu virus because their immune systems can be weaker than someone who does not have diabetes. To complicate matters, it can be hard to keep blood sugars controlled when you get sick.

Woman with cold blowing her nose in bed
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While the body tries to fight the illness, hormones are released that cause blood sugars to rise and interfere with the blood-glucose lowering effects of insulin, making diabetes harder to control . How you manage your diabetes when you are sick is an important part of managing your condition overall.

Medications for Treating Cold and Flu Symptoms in Diabetics

One of the questions that comes up often is, what can someone with diabetes take that is over the counter if they do get sick? This can be confusing because there are so many brands of cold and flu medications to choose from. You can buy single symptom medicines that treat just coughs or just nasal congestion. Or you can buy a product that will help with several symptoms at once.

The trick is to know what ingredients are in the medications that you buy, and how they will affect your diabetes. Ingredients on the labels fall under two categories: inactive and active. Inactive ingredients don't have medicinal value. They are typically fillers, flavorings, colorings, and substances that help with consistency. Active ingredients are the drugs that actually treat the symptoms.

Find out the ingredients of your typical over-the-counter medicines and how they can affect your diabetes:

Inactive Ingredients That May Affect Diabetes

Alcohol or sugar are non-pharmacological ingredients that may be in the cold and flu medicine you are taking. They may be listed under "inactive ingredients" on the label. Both alcohol and sugar will affect your blood glucose levels. These can cause blood sugars to rise.

Active Ingredients That May Affect Diabetes

Pain and fever reducers: acetaminophen which can be used for minor aches and fevers associated with the cold and flu.

  • Acetaminophen can be toxic to liver and kidneys. People with diabetes who also have kidney complications should check with their healthcare provider before using acetaminophen.
  • NSAIDS: (Non-steroidal anti-inflammatory drugs) are used to treat aches, pains, and fevers associated with colds and flu.
  • Ibuprofen should be used cautiously by people with liver and kidney problems. It also increases the hypoglycemic effect (low blood sugar) of insulin and oral diabetes medications when used in high doses.
  • Naproxen should not be used for people with severe cardiovascular disease, or kidney or liver problems. It may also increase the risk of hypoglycemia with insulin and oral diabetes medications when used in high doses.

Cough Medications

  • Dextromethorphan is an ingredient in many cough preparations and at recommended doses is safe for people with diabetes.
  • Guaifenesin is an ingredient that loosens mucus and makes it easier to cough it up. There are no warnings about guaifenesin and diabetes.
  • Decongestants
  • Epinephrine, phenylephrine, and pseudoephedrine are usually found in nasal sprays, but also some oral cold medicines. They work by drying up secretions in the nasal passages. It is possible that they could decrease the effects of insulin or oral diabetes medications. They can also increase blood pressure and should be used cautiously in people with high blood pressure.
  • Phenylpropanolamine (PPA) is a decongestant that has been recalled by the FDA as of 2005, due to an increased risk of strokes.


  • Brompheniramine, chlorpheniramine, and doxylamine are used in combination with other active ingredients. These antihistamines do not affect diabetes directly, but elderly people may be more susceptible to side effects. Diphenhydramine is used alone (marketed as Benedryl) or in combination with other drugs. It can cause low blood pressure in some people.
  • Loratadine is a second generation antihistamine that has recently gone OTC. It does not cause the sedation associated with the older antihistamines. It does not appear to cause problems in people with diabetes.

A Word From Verywell

Navigating the cold and flu aisle at your drug store can be challenging because of all the different brands and combinations of drugs available. Remember that these medications will not cure a cold or a flu; they only temporarily ease the symptoms.

The best way to prevent complications or medication-related side effects is to discuss with your healthcare provider or your pharmacist which of these medications is right for you.

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10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Flu and people with diabetes. Updated October 24, 2019.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Take care of your diabetes during sick days & special times. Updated February 2014.

  3. Pharmacy Times. Cough and cold products for patients with diabetes. Updated October 1, 2008.

  4. Harvard Health Publishing. 10 things you should know about common pain relievers. Updated August 22, 2018.

  5. Li J, Zhang N, Ye B, et al. Non-steroidal anti-inflammatory drugs increase insulin release from beta cells by inhibiting ATP-sensitive potassium channels. Br J Pharmacol. 2007;151(4):483-93. doi:10.1038/sj.bjp.0707259

  6. MedlinePlus. Guaifenesin. Updated February 15, 2018.

  7. Diabetes in Control. Drugs that can affect blood glucose levels. Updated 2011.

  8. Food and Drug Administration. Phenylpropanolamine (PPA) information page. Updated October 14, 2016.

  9. Benadryl: 7 things you should know. Updated December 28, 2019.

  10. Yanai K, Yoshikawa T, Yanai A, et al. The clinical pharmacology of non-sedating antihistamines. Pharmacol Ther. 2017;178:148-156. doi:10.1016/j.pharmthera.2017.04.004

Additional Reading
  • American Academy of Family Physicians .Types of OTC medicines and how they work. Apr 29, 2020.

  • Deglin, Judith Hopfer, PharmD; Vallerand, April Hazard, PhD, RN, Davis's Drug Guide. 5th. Philadelphia: F. A. Davis Company.