Drugs
My son was told that people with diabetes should not use Betnovate cream because it contains steroids. Is this true and why?
Most skin specialists avoid using powerful steroid creams such as Betnovate unless there is a serious skin condition. Very often a weak steroid preparation or some bland ointment is just as effective in clearing up mild patches of eczema and other rashes. Unfortunately too often the very strong steroids are often used first, instead of as a last resort. These strong steroids can be absorbed into the body through the skin and lead to a number of unwanted side effects. This advice applies to all people with skin problems and not just people with diabetes. One of the side effects of steroids is a rise in the blood glucose level. Thus, someone without diabetes may develop it while taking steroids and a person treated with diet only may need to go onto tablets or insulin. If there are good medical reasons for your son to take steroids, in whatever form, he should be prepared to test his blood for signs of poor control. If he is already taking insulin, the dose may need to be increased.
Can you tell me if any vaccinations including BCG are dangerous for people with diabetes?
There is no reason why a child should not have full immunization against the usual diseases. Sometimes inoculation is followed by a mild ’flu-like illness, which may lead to a slight upset of diabetes control. This is no reason to avoid protecting your child against measles, whooping cough, etc. In some areas school children are given BCG as a protection against tuberculosis. Children should also have the normal immunization procedures if they are travelling to exotic places.
My wife suffers from bad indigestion. She is afraid to take indigestion tablets in case they upset her diabetes. Can you advise what to do?
Indigestion tablets and medicines do not upset diabetes. Is it safe to take water tablets (diuretics) with diabetes?
Diuretics are given to people who are retaining too much fluid in the body. This fluid retention may happen in heart failure and cause swelling of the ankles or shortness of breath. Diuretics are usually very effective but, as a side effect, they may cause a slight increase in the blood glucose. This is especially true of the milder diuretics such as Navidrex, which belong to the thiazide group. The increase in glucose is only slight but can sometimes mean that someone controlled on diet alone may need to take tablets.
People already on insulin are not affected by diuretics. The thiazide group of tablets is also used in the treatment of raised blood pressure.
Is there any special cough mixture for people with diabetes?
There are various sugar-free cough mixtures that can be bought from your chemist. However, there is only a tiny bit of sugar in a dose of ordinary cough mixture and this amount is not going to have any appreciable effect on the level of blood glucose. I have been on insulin for diabetes for 7 years.
I was recently found to have raised blood pressure and was given tablets, called beta-blockers, by my doctor. Since then I have had a bad hypo in which I collapsed without the normal warning signs of sweating, shaking, etc. Could the blood pressure tablets have caused this severe hypo?
Beta-blockers are widely used for the treatment of high blood pressure and certain heart conditions. They have an ‘anti-adrenaline’ effect, which theoretically could damp down the normal ‘adrenaline’ response to a hypo. However, research has shown that beta-blockers do not reduce the adrenaline warning of a hypo. Some beta-blockers have been designed to have their effect only in the heart without blocking the general adrenaline reaction. These selective beta-blockers are theoretically safer for people taking insulin.
Please could you give me a list of tablets or medicines that may interfere with my diabetes?
There are no medicines that must never be used but the following might increase the blood glucose and upset your control:
• Steroids (e.g. prednisolone, Betnovate ointment) and steroid inhalers (e.g. Becotide) – taken in tablet form may cause a rise in blood glucose level but inhalers or ointment will have this effect only in very large doses
• Thiazide diuretics (e.g. Navidrex, Neo-Naclex)
• The contraceptive pill
• Hormone replacement therapy (e.g. Harmogen, Prempac, Trisequens, Progynova)
• Certain bronchodilators (e.g. Ventolin) – might have a slight effect on raising the blood glucose
• Aspirin – in large doses might lower blood glucose
• Growth hormone treatment.
