# Acetaminophen, CGM and blood sugar

**URL:** <https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920>\
**Category:** Type 1 & LADA\
**Tags:** acetaminophen\
**Created:** [September 11, 2017, 12:30am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920 "2017-09-11T00:30:30Z")\
**Posts on this page:** 13\
**Page:** 1

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**Author:** ![Irish](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/irish/32/57_2.png) [@Irish](https://forum.fudiabetes.org/u/Irish)\
**Post date:** [September 11, 2017, 12:30am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/1 "2017-09-11T00:30:30Z")

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Could someone please help enlighten my addled, sick brain about why acetaminophen is not a good option? Is it that it actually spikes the blood sugar or that it prohibits the CGM sensor from taking accurate measurements?

I know Ibuprofen is fine to take, but I could sure go for some Nyquil right about now.

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**Author:** ![Eric](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/eric/32/9209_2.png) [@Eric](https://forum.fudiabetes.org/u/Eric)\
**Post date:** [September 11, 2017, 12:31am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/2 "2017-09-11T00:31:54Z")

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> [@Irish](#):
>
> Is it that it actually spikes the blood sugar or that it prohibits the CGM sensor from taking accurate measurements?

It doesn’t do anything to BG, it just screws up the sensor reading.

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**Author:** ![docslotnick](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/docslotnick/32/75_2.png) [@docslotnick](https://forum.fudiabetes.org/u/docslotnick)\
**Post date:** [September 11, 2017, 12:54am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/3 "2017-09-11T00:54:18Z")

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@Irish There have been times that I felt like a good dose of Nyquil was more important to me than relying on my Dexcom.

Don’t be a slave to your CGM. Take the Nyquil, test with your meter, and get a good night’s sleep.

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [September 11, 2017, 1:20am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/4 "2017-09-11T01:20:44Z")

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Here is an interesting recent study that discusses acetaminophen’s interference with subcutaneous glucose sensing:

> **[Direct Evidence of Acetaminophen Interference with Subcutaneous Glucose...](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717519/)**
>
> Background: Recent advances in accuracy and reliability of continuous glucose monitoring (CGM) devices have focused renewed interest on the use of such technology for therapeutic dosing of insulin without the need for independent confirmatory blood...

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**Author:** ![CatLady](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/catlady/32/36_2.png) [@CatLady](https://forum.fudiabetes.org/u/CatLady)\
**Post date:** [September 11, 2017, 2:39am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/5 "2017-09-11T02:39:15Z")

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The G6, whenever it will be released, is supposed to be able to be used for acetaminophen, FWIW.

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [September 11, 2017, 3:31am UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/6 "2017-09-11T03:31:54Z")

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> [@CatLady](#):
>
> able to be used for acetaminophen

I had no idea. So I looked it up and found an announcement that mentions that on the Motley Fool:

> **[The Motley Fool Sits Down With the CEO of Dexcom Inc. | The Motley Fool](https://www.fool.com/investing/general/2016/03/13/the-motley-fool-sits-down-with-the-ceo-of-dexcom-i.aspx)**
>
> In this hour-long interview, Motley Fool healthcare contributor Brian Feroldi asks a diabetes visionary about where his company is today and what kind of innovations are possible in the years ahead.

Our own @dm61 analyzed that release last year on tuD:

> **[TuDiabetes Forum](https://forum.tudiabetes.org/)**
>
> A community of people touched by diabetes.

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<div class="post-metadata">

**Author:** ![Spinlady](https://avatars.discourse-cdn.com/v4/letter/s/35a633/32.png) [@Spinlady](https://forum.fudiabetes.org/u/Spinlady)\
**Post date:** [September 11, 2017, 4:17pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/7 "2017-09-11T16:17:48Z")

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So…I shouldn’t take Acetaminophen, and my Endo tells me not to take ibuprofen…what should I be able to use?

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**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [September 11, 2017, 4:24pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/8 "2017-09-11T16:24:41Z")

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Hmm. Why does he say that?

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**Author:** ![Spinlady](https://avatars.discourse-cdn.com/v4/letter/s/35a633/32.png) [@Spinlady](https://forum.fudiabetes.org/u/Spinlady)\
**Post date:** [September 11, 2017, 4:27pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/9 "2017-09-11T16:27:33Z")

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Possible Kidney issues after 35 years as a Type 1.

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<div class="post-metadata">

**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [September 11, 2017, 4:31pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/10 "2017-09-11T16:31:58Z")

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Another alternative is aspirin, but I believe there are also possible kidney issues.

Aspirin is another one of those medicines that seem to have upside in many different directions.

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<div class="post-metadata">

**Author:** ![Spinlady](https://avatars.discourse-cdn.com/v4/letter/s/35a633/32.png) [@Spinlady](https://forum.fudiabetes.org/u/Spinlady)\
**Post date:** [September 11, 2017, 4:37pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/11 "2017-09-11T16:37:46Z")

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It kind of sucks, but I will still be taking acetaminophen and watching my BG levels with finger sticks.

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<div class="post-metadata">

**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\
**Post date:** [September 11, 2017, 4:56pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/12 "2017-09-11T16:56:36Z")

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Acetominophen appears to be the only recommended NSAID for people with kidney issues ☹

Even baby aspirin doses appear to affect kidney function for those with hypoalbuminemia (very few patients in this study though):

> <https://www.ncbi.nlm.nih.gov/pubmed/10643705>
>
> Aspirin is known to have a bimodal effect on the renal handling of uric acid (UA). High dosages (\>3 gm/day) are uricosuric, while low dosages (1-2 gm/day) cause UA retention. Although very-low-dose (mini-dose) aspirin is used increasingly as a platelet aggregation inhibitor, no studies have been published on whether aspirin's renal effects occur at dosages of \<0.5 gm/day. The aim of the present study was to evaluate the effects of commonly used mini-dosages of aspirin on renal function and UA handling in elderly patients.The study included 49 elderly inpatients (age 61-94). Patients were excluded if they had renal failure, hyperuricemia, gout, or a history of bleeding, or if they were receiving anticoagulants, aspirin, or nonsteroidal antiinflammatory drugs. Previous medications and diet were kept unchanged. Aspirin was administered as follows: 75 mg/day (week 1), 150 mg/day (week 2), 325 mg/day (week 3), and 0 mg/day (week 4). Baseline and weekly samples of blood and urine were evaluated for UA, creatinine, blood urea nitrogen, creatinine clearance, UA excretion, UA clearance, and plasma levels of aspirin.At the lowest dosage, aspirin caused a 15% decrease in the rate of UA excretion (P = 0.045 by t-test), which was associated with a slight but significant increase in serum levels of UA (P = 0.009). These effects on UA levels were gradually reduced with increasing dosages of aspirin (multivariate analysis of variance with repeated measures showed no statistically significant difference in the rate of UA excretion between weeks 1-3 and week 0 \[baseline\], but the difference in serum UA levels for the same comparison was statistically significant \[P = 0.038\]). Generally, creatinine and UA clearance rates paralleled each other during aspirin treatment. However, 1 week after aspirin was discontinued, creatinine clearance remained decreased while UA clearance returned to baseline. Plasma aspirin concentrations were low and variable. However, patients with above-median aspirin levels had significantly greater changes in serum creatinine levels, urinary UA excretion rates, and UA clearance rates following the first week of aspirin treatment. Hypoalbuminemia and concomitant treatment with diuretics enhanced the effects of aspirin on renal function and UA retention.Mini-dose aspirin, even at a dosage of 75 mg/day, caused significant changes in renal function and UA handling within 1 week in a group of elderly inpatients, mainly in those with preexisting hypoalbuminemia. Given the widespread (and often unmonitored) use of mini-dose aspirin, especially among the elderly, these findings call for clinician alertness as well as for further studies to clarify the mechanisms underlying these phenomena.

At the same time, doing a risk/ benefit analysis still shows positive benefits to using such drugs as aspirin, for instance for hypertensive people:

> **[Aspirin Is Beneficial in Hypertensive Patients With Chronic Kidney Disease](http://www.onlinejacc.org/content/56/12/956)**
>
> Objectives The purpose of this study was to determine the benefit and risk associated with antiplatelet therapy in the chronic kidney disease (CKD) population.
> 
> Background Cardiovascular and possibly bleeding risks are elevated in patients with CKD....

So looking only at the risk part of the balance sheet may not always give a full picture. I would love to read some more detailed analysis of the use of NSAIDs for people with diabetes.

[EDIT] More evidence that low-level aspirin has a positive effect on mortality of people with kidney disease:

> **[Acetaminophen, Aspirin, and Renal Failure | NEJM](https://www.nejm.org/doi/full/10.1056/NEJM200205163462017)**
>
> Correspondence from The New England Journal of Medicine — Acetaminophen, Aspirin, and Renal Failure

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<div class="post-metadata">

**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\
**Post date:** [September 11, 2017, 4:57pm UTC](https://forum.fudiabetes.org/t/acetaminophen-cgm-and-blood-sugar/1920/13 "2017-09-11T16:57:21Z")

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> [@Irish](#):
>
> why acetaminophen is not a good option

I will attempt to answer your question. The glucose sensor systems on the market all use an electrochemical sensor. In order to work, the the sensor must be poised at a specific potential. At the potential they currently poise them the sensor will “see” the glucose signal and the interferent (acetaminophen) signal at the same time. So, the acetaminophen current will be added to the glucose signal thereby rendering the data ineffective for the time the interferant is present. In practice, you will see an artificially high bg during the time the acetaminophen is active in your system.

Interferents that you run into in daily life include Ibuprofen and ascorbic acid.

As @docslotnick said, if you need the meds, take them, and ignore your CGM during this time and rely on meter readings instead.