Sneezes and Wheezes: Seasonal Allergies and Diabetes

Spring is really starting to burst out here in Massachusetts. The tulips are blooming and leaves and buds are popping out on the trees. As pretty and welcoming as this is, many of you (about 50 million!) are probably bracing yourself for all of the pollen that is soon to follow, and suffering through the misery that it can bring. Thanks to the mild winter that we had in the Northeast, plants are pollinating earlier than usual. As if that weren’t bad enough, having seasonal allergies can also affect your blood sugar control.

Seasonal allergies: do you have them?
Seasonal allergies are sometimes called hay fever or, more technically, seasonal allergic rhinitis. You might be wondering if your symptoms are due to a cold, flu, or allergies. While there can be some overlap, the following symptoms are usually indicative of allergies:


• Itchy eyes
• Watery eyes
• Dark circles under the eyes
• Sneezing
• Runny nose
• Stuffy nose
• Sore throat

You might also feel a little bit tired. You won’t get a fever from allergies, however. These symptoms can linger for weeks unless they’re treated.

Treating allergies
There are a number of remedies for seasonal allergies, including oral medications, nasal sprays, and eye drops. It’s important that you not only choose the right one for your symptoms, but that you also are aware of how these medicines might affect your blood sugars. The following types of allergy medicines may affect your blood glucose levels or how you manage them:

Antihistamines. These medicines can reduce sneezing, runny nose, and itchy and watery eyes. Common antihistamines include diphenhydramine (Benadryl), loratidine (Alavert, Claritin), cetirizine (Zyrtec Allergy), and fexofenadine (Allegra Allergy). Antihistamines might be combined with a decongestant. They’re also available by prescription. Some of these medications can cause drowsiness.

Effect on diabetes: Antihistamines tend to not directly affect blood sugar levels. However, if you take the kind that makes you sleepy, you might not pick up on symptoms of high or low blood sugars. Ask your pharmacist about non-sedating antihistamines.

Decongestants. Decongestants help to temporarily relieve a stuffy nose. They’re available as oral medicines, such as pseudoephedrine (Sudafed, Afrinol) and as the nasal sprays oxymetazoline nasal (Afrin) and phenylephrine nasal (Neo-Synephrine).

Effect on diabetes: Decongestants may raise blood sugars, at least in some people. If you take insulin, you may need to adjust your dose. Be extra diligent about checking your blood sugars if you take a decongestant. Also note: Decongestants may raise your blood pressure and your heart rate. Talk with your doctor or pharmacist before taking a decongestant if you already have high blood pressure or an increased heart rate.

Corticosteroids. Also called steroids or glucocorticoids, these medicines block allergic reactions by reducing and treating inflammation. They can address a number of allergy symptoms, all at the same time. Corticosteroids are available in pills, nasal sprays, inhalers, liquids, eye drops, and creams (for skin reactions). They may be combined with other types of allergy medicines, too. Many corticosteroids are available only by prescription, but you can now purchase over-the-counter versions, as well. Common brands of these medicines include beclomethasone (Beconase, Qvar), fluticasone (Flonase, Flovent), and triamclionolone (Nasacort AQ). Oral steroids may be Medrol or Deltasone, which are prednisone.

Effect on diabetes: Steroids are powerful medications, but when it comes to diabetes, the main side effect is high blood sugars (hyperglycemia). This happens because steroids block the effect of insulin, causing insulin resistance. They also trigger the liver to release glucose. You need to frequently check your blood sugar when taking any of these medicines. Call your doctor or diabetes educator if your blood sugars go up and stay up — you may need to increase your diabetes medicine or insulin dose.

Preventing allergic symptoms
Try preventing the misery of seasonal allergies in the first place by taking the following steps:

• Close the windows in your house and your car to keep the pollen out.

• Shower after being outside to remove pollen from your skin and hair.

• Exercise indoors if the pollen count is high.

• Dust your home often, and clean rugs and curtains regularly.

• Vacuum often, as well, and use a vacuum with a HEPA filter.

• If your basement is damp, use a dehumidifier to discourage mold from growing.

• Wear a microfiber mask if you’re outside doing yard work.

• Get more probiotics (good bacteria) in your diet. Sources include yogurt, kefir, kombucha, sauerkraut, and sour pickles.

• Rinse your nasal passages with a saline solution using a neti pot.

• Try taking quercetin or stinging nettle, which are dietary supplements that may prevent allergy symptoms. Check with your doctor or pharmacist first, though.

If your allergies aren’t responding to any of the above medicines or suggestions, talk with your doctor to find out if allergy shots might be a good option for you.