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Dr. Bill's Commentaries

Coming Up on Flu Season   (September 27, 2013)

It’s autumn, and flu season is due to start again soon. And for people with diabetes, the flu can be deadly. The CDC states that if you have diabetes, you are three times more likely to be hospitalized and three times more likely to die from the flu and its complications than other people. 

The CDC lists the symptoms of flu as including:

  • Fever (may not necessarily be present)
  • cough
  • sore throat
  • runny or stuffy nose
  • body aches
  • headache
  • chills
  • fatigue
  • some people may also have vomiting and diarrhea.

If you have diabetes, even if your blood sugars are in good control, and get sick with flu-like illness, the CDC suggests that you should follow these additional steps:

  • Be sure to continue taking your diabetes pills or insulin. Don’t stop taking them even if you can’t eat. Your health care provider may even advise you to take more insulin during sickness.
  • Test your blood glucose every four hours, and keep track of the results.
  • Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can’t, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume.
  • Weigh yourself every day. Losing weight without trying is a sign of high blood glucose.
  • Check your temperature every morning and evening. A fever may be a sign of infection.
  • Call your health care provider or go to an emergency room if any of the following happen to you:
    • You feel too sick to eat normally and are unable to keep down food for more than 6 hours.
    • You're having severe diarrhea.
    • You lose 5 pounds or more.
    • Your temperature is over 101 degrees F.
    • Your blood glucose is lower than 60 mg/dL or remains over 300 mg/dL.
    • You have moderate or large amounts of ketones in your urine.
    • You're having trouble breathing.
    • You feel sleepy or can't think clearly.

It’s widely accepted that getting an influenza vaccination or “flu shot” is the best way to prevent getting flu. The flu shot is an inactivated vaccine (that is, it contains killed virus) that is given with a needle, usually in the upper arm. This kind of flu shot is approved for use in people older than six months, including healthy people and people with chronic medical conditions including diabetes. There are different variants of the flu shots that are available: a regular flu shot approved for people ages 6 months and older; a high-dose flu shot (called Fluzone) approved for people 65 and older, an intradermal (into the skin) flu shot approved for people 18 to 64 years of age; and a vaccine for ages 18-49 that doesn’t use influenza virus nor chicken eggs in manufacturing (Flublok). BTW, the CDC hasn’t recommended Fluzone vs. the regular flu shot for people over 65.

There is also a flu vaccine that is given as a nasal spray, brand name FluMist, which is made with live weakened flu viruses (which do not cause the flu). The CDC states that “the nasal spray vaccine should not be given to people with diabetes.”

There also are  antiviral drugs that can be used to treat and prevent the flu.

The CDC also reminds us that “people with type 1 or type 2 diabetes are at an increased risk of developing pneumonia from the flu, therefore a pneumonia (pneumococcal) vaccine is also recommended for them.” Unlike the flu shot, one injection of the pneumonia vaccine lasts for many years.

The CDC’s website has several webpages with information about the flu for people with diabetes:

Seasonal Influenza (Flu) (updated for 2013-2014)

Diabetes & Flu: What You Need to Know and Do

Diabetes & the Flu

Flu and People with Diabetes

Protect Yourself from Influenza (The Flu)

To wrap up: If you haven’t done so already, plan to get a flu shot soon. It’s that time of year.

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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This page was new at D-is-for-Diabetes April 30, 2014

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