Flu & People with Diabetes

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People with diabetes (type 1, type 2, or gestational), even when well-managed, are at higher risk of developing serious flu complications, which can result in hospitalization and sometimes even death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. In recent seasons, about 30% of adults hospitalized with flu reported to CDC had diabetes. Flu also can make chronic (long-term) health problems like diabetes worse because these conditions can make the immune system less able to fight off infections. Furthermore, acute illnesses like flu can make it harder to control your blood sugar levels. Flu may raise your blood sugar levels, but sometimes people don’t feel like eating when they are sick and a reduced appetite can cause blood sugar levels to fall. It is important for people with diabetes to follow the sick day guidelines if they become ill.

Diabetes is a chronic disease that affects how your body turns food into energy. 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).

A Flu Vaccine is the Best Protection Against Flu

Flu vaccination is especially important for people with diabetes because they are at higher risk of developing serious flu complications. Because flu vaccines are updated each season to keep up with changing viruses and immunity provided by flu vaccination decreases over time, annual vaccination is recommended for the best protection against flu. Flu vaccines protect against the four flu viruses that research indicates will be most common during the upcoming season. More information on why flu vaccines may be updated annually is available:  Vaccine Virus Selection, as well as this season’s exact vaccine composition. Flu vaccines for the upcoming season have been updated to better match the viruses that are expected to circulate. Immunity from flu vaccination sets in after about two weeks after getting vaccinated.

CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year, ideally by the end of October.

Flu Vaccines for People with Diabetes

Get pneumococcal vaccines.

  • Having flu increases your risk of getting pneumococcal disease. Pneumonia is an example of a serious complication that can cause death.
  • People who have diabetes also should be up to date with pneumococcal vaccination to help protect against pneumococcal disease. Pneumococcal vaccination should be part of a diabetes management plan. Talk to your health care provider to find out which pneumococcal vaccines are recommended for you.

Other Preventive Actions for People with Diabetes

In addition to getting a flu vaccine, people with diabetes should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often.

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In the context of the COVID-19 pandemic, local governments or public health departments may recommend additional precautions be taken in your community. Follow those instructions.

Specific Health Actions for People with Diabetes

  • Plan ahead to maintain sufficient supplies of your regular medications for chronic medical conditions (e.g., at least a 2-week supply)

Symptoms and Treatment

If you get flu symptoms call your health care provider right away. There are antiviral drugs that can treat flu illness and that may prevent serious flu complications. CDC recommends prompt flu treatment for people who have flu infection or suspected flu infection and who are at higher risk of serious flu complications, such as people with diabetes.

Symptoms

Flu symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue. Some people also may have vomiting and diarrhea, though this is more common in children than in adults. People may be infected with flu and have respiratory symptoms without a fever.

Treatment

  • Influenza antiviral drugs are medicines that fight against flu by keeping flu viruses from making more viruses in your body.
  • 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.
  • Treatment with an influenza antiviral drug should begin as soon as possible because these medications work best when started early (within 48 hours after symptoms start).
  • You need a prescription from a health care provider for an influenza antiviral medication.
  • There are four FDA-approved flu antiviral drugs recommended by CDC this season that can be used to treat flu.

When to Seek Emergency Medical Care

Anyone experiencing any of the following emergency warning signs of flu sickness, including people with diabetes, should seek medical attention right away.

Emergency Warning Signs of Flu
Emergency Warning Signs of Flu
In children
  • Fast breathing or trouble breathing
  • Bluish lips or face
  • Ribs pulling in with each breath
  • Chest pain
  • Severe muscle pain (child refuses to walk)
  • Dehydration (no urine for 8 hours, dry mouth, no tears when crying)
  • Not alert or interacting when awake
  • Seizures
  • Fever above 104°F
  • In children less than 12 weeks, any fever
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions
In adults
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest or abdomen
  • Persistent dizziness, confusion, inability to arouse
  • Seizures
  • Not urinating
  • Severe muscle pain
  • Severe weakness or unsteadiness
  • Fever or cough that improve but then return or worsen
  • Worsening of chronic medical conditions

These lists are not all inclusive. Please consult your medical provider for any other symptom that is severe or concerning. 

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