As flu season intensifies, we’re exposed to more messages about getting the flu shot. This is because last year, we experienced the deadliest flu season in decades. More than 80,000 Americans died due to flu complications. That number is the equivalent to having about 192 planes that can accommodate 416 passengers falling from the sky. This is the 100th year anniversary of the deadly flu pandemic of 1918, when 675,000 Americans died, and globally, more than 50 million people were killed. Since then, we’ve learned and continue to learn how to protect the public — especially people with chronic diseases.
As a nurse practitioner who specializes in diabetes, I take special care to educate my patients this time of year.
Flu and Diabetes
There are three main types of diabetes: Type 1, Type 2 and gestational diabetes (diabetes while pregnant). More than 100 million Americans are living with diabetes (30.3 million) or prediabetes (84.1 million). People with diabetes (Type 1, Type 2 or gestational), even when well-managed, are at high risk of severe flu complications, which can result in hospitalization and sometimes even death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu can also make chronic health problems, like diabetes, worse. This is because diabetes can make the immune system less able to fight infections. In addition, illness can make it harder to control your blood sugar.
The best way to stay safe is to get your flu vaccination as soon as possible from your health care provider or local pharmacy. This is especially important for people with diabetes because they are at high risk of developing serious flu complications. Remember, the flu vaccines are updated each season to keep up with changing viruses.
It typically takes about two weeks to get protection from the vaccine. Flu vaccination has been shown to reduce the risk of getting sick with flu, plus the risk of having a serious flu outcome like a stay in the hospital or even being admitted to the intensive care unit. Flu vaccination has also been associated with reduced hospitalizations among people with diabetes (79 percent). It’s very important to remember the flu vaccine does not cause the flu.
Symptoms of the flu include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea, and it’s possible to have respiratory symptoms without a fever. If you get sick with flu symptoms, call or visit your doctor right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications, and treatment works best when started early (within 48 hours of symptoms appearing). Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness. The Centers for Disease Control and Prevention recommends prompt treatment for people who have influenza infection or suspected influenza infection and who are at high risk of serious flu complications, such as people diagnosed with diabetes.
What to Do if You Think You Have the Flu
If you have diabetes, getting the flu might raise your blood sugar levels. Eating small meals is necessary to keep these levels under control, and you need to continue taking your diabetes medicine. In fact, you may need to increase or change your medicine because your blood sugar may rise. Still, you have to eat to keep your blood sugar levels steady, so try to stick to food from your regular meal plan.
It’s important to develop sick-day guidelines with your health care team; you’ll need to check in often. And it’s a smart idea to train one or two family members or friends in blood glucose monitoring and other ways to help when you’re sick. Because you’re ill and feel awful anyway, you may not notice changes in your blood sugar levels. Call your health care provider about any major changes, since you may need to adjust your insulin. If you have diabetes Type 1 and notice high blood sugar levels, check for ketones in your urine, since you could experience diabetic ketoacidosis, or DKA — a serious condition that requires immediate attention. If left untreated, DKA can cause a coma or even death.
Even when you are feeling at your worst it is important to stay vigilant about your diabetes care and take good care of yourself. Drink plenty of fluids (water or other non-caloric drink) to prevent dehydration.
Emergency Warning Signs of Flu Sickness
Call your health care provider if any of the following occurs:
— You have moderate to high ketone levels in your urine.
— You have not eaten normally for more than 24 hours.
— You have a fever over 101 degrees for 24 hours.
— You can’t keep any liquids down for more than four hours.
— You have vomiting and/or diarrhea for more than six hours.
— You lose 5 pounds or more during the illness.
— Your blood glucose reading is under 60 mg/dl or over 300 mg/dl.
— You have trouble breathing.
— You can’t stay awake or think clearly.
If you cannot think clearly or feel too sleepy, have someone else call your health care provider or take you to the emergency room.
Questions to Ask Your Health Care Team
— Do I have a written plan from my medical team to guide me on sick days?
— Have I made a sick day box with needed medicines and foods?
— Have I trained at least two people who can help me if I’m sick?
More from U.S. News