Drug Caution Code - Code S

Code S: Diabetes

Consult your pharmacist if you are diabetic.

(Remember S for sugar)
Code S refers to:
Sugar containing products: more than 12 kcal per dosage
Topical keratolytic salicylic acid products: wart, corn and callous removers
Lactase Enzyme products: lactase, alpha-galactoside (Beano R)

Diet is the basis of diabetes therapy. The caloric content of pharmaceuticals is an important consideration. Products containing 12 calories or more per dose are considered to have a significantly high caloric content and should be avoided by diabetics. "Sugarless" and "dietetic" do not mean that the product is safe for diabetics. The type of sugar is also important. Glucose, dextrose, fructose, and lactose are as caloric as sugar and can elevate glycemia. Sorbitol, xylitol and mannitol are as caloric as sugar but have a lesser effect on blood sugar. Acceptable substitutes for sugar-restricted diets are sorbitol, because it does not contribute to long-term diabetic complications, saccharin and aspartame.

Lozenges can represent a large caloric intake. Several common lozenges are listed in high and low sugar contents.

High Sugar Content	Low Sugar Content
Bradosol Lozenges Beechnut Cough Drops Dequadin Mints (15 kcal) Halls Honey-lemon cough lozenge Rheila Medicated Cough Drops Ricola Swiss Herb Cough Drops Sucrets Valda pastilles Vick's Throat Drops	Bentasil lozenges (7 kcal) Bionet lozenges Cepacol lozenges (8 kcal) Cepacol Anesthetic lozenge (8 kcal) Cepastat lozenge (7.7 kcal) Chloraseptic lozenges Dequadin lozenge (4.29 kcal) Fisherman's Friend lozenges (all types=4 kcal) Meggezones (3.04 kcal) Soothease Throat Drops

Topical Keratolytics

Topical preparations containing salicylic acid, lactic acid and glacial acetic acid are used as keratolytic agents in the treatment of corns, callouses and warts. People with diabetes have poor peripheral circulation and may be unable to effectively repair tissue damage to areas surrounding the corn or wart. Infection can result and is a major complication with diabetes.

People with diabetes should be referred to a physician or foot care specialist for treatment of corns, callouses, ingrown toenails and warts.

Enzyme Products

Lactase enzyme products break down the calcium lactate in milk products to aid in their digestion and alpha-galactosidase products break down complex carbohydrates into simple sugars. These sugars are then made metabolically available and the extra calories must be accounted for by patients with diabetes.