Since I have diabetes, should I worry about the sugar in cough and cold medicines?


People with diabetes do need to think twice before buying over-the-counter (OTC) cough, cold and flu medications. Many of these medications contain various forms of sugar, often in the form of high-fructose corn syrup—but the labels don’t state how much sugar the product contains per dose. It’s a dilemma because in some cases the carbs, mostly from sugar, are so high it’s equivalent to a snack—and that affects blood sugar. The products I have investigated vary greatly from having just a few milligrams of carbs per dose to having as much as 24 grams—about as much as you'd find in a Hershey's chocolate bar! To confuse matters further, some have alcohol in them, which can reduce blood sugar levels...while being sick in the first place can increase blood sugar levels. My first bit of advice: Keep your blood sugar under control when you are well. If your blood sugar is consistently well-managed, an occasional rise in blood sugar from a medication isn't a concern, and you should be fine taking an OTC medication for a few days. But if your blood sugar is often elevated or is hard to control, be especially careful when buying these medications...

  • Be a carb sleuth. Most cough and cold liquid preparations have some sugar to make them taste better. Look for tell-tale ingredients that spell S-U-G-A-R—high-fructose corn syrup, corn syrup or sucrose. But being listed as an ingredient doesn’t answer how much sugar is in the product. My own informal investigation has found that Robitussin Cough + Chest DM came in very low (0.67 grams (g) of carbs per adult dose) and Delsym Cough 12 Hour Cough Relief was low (3.6 g of carbs per adult dose). But NyQuil Cold & Flu Nighttime Relief Liquid has 20 g, and DayQuil Cold & Flu Relief Liquid has 23.8 g. If you're taking DayQuil every four to six hours, and NyQuil at night, that adds up to a lot of extra carbs!
  • Go sugar-free. You may be able to find sugar-free cough medications, aka “diabetic” varieties. Examples: Sugar-free Robitussin and Diabetic Tussin (which is both sugar- and alcohol-free).
  • Choose pills instead. Some cough and cold preparations now are available in pill or capsule form. These don’t contain carbs because they don’t need the taste-improving sugar.
One final tip: Keep it simple. Many cold and flu preparations contain a lot of different medications to treat a wide variety of symptoms, but you may need only one of these ingredients. If you have a dry cough, you may need only a cough suppressant, not something that also contains an antihistamine for a runny nose and a fever reducer. If you are just congested, you may not need the cough suppressant at all—and could more easily avoid these liquid medications entirely.