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Having the flu can be dangerous for anyone. But it is extra risky for people with diabetes or other chronic health problems.

For people with diabetes, the flu can be more than aches and pains. It can mean longer illness, hospitalization, even death. Because diabetes can make the immune system more vulnerable to severe cases of the flu. In fact, people with diabetes are almost 3 times more likely to die with influenza (“the flu”) or pneumonia.

In general, every person with diabetes needs a flu shot each year. Talk with your doctor about having a flu shot. Flu shots do not give 100% protection, but they do make it much harder for you to catch the flu for about 6 months.

Why get vaccinated against the flu?

Influenza is a serious disease that can lead to hospitalization and sometimes even death.  Every flu season is different, and the flu infection can affect people differently.  Even healthy people can get very sick from the flu and spread it to others.  During a regular flu season, about 90 percent of deaths occur in people 65 and older.  Flu season in the United States can begin as early as October and last as late as May.

During this time, flu viruses are circulating in the population.  An annual seasonal flu vaccine is the best way to reduce the chances that you will get seasonal flu and lessen the chance that you will spread it to others.  When more people get vaccinated against the flu, less flu can spread through that community.

If you have diabetes, it’s wise to take steps to protect yourself from both regular flu and H1N1, or swine flu, experts say, since you’re more at risk for complications of the flu than people in other groups. Simply being sick at all, with a cold or the flu, can increase your blood glucose, and it may keep you from eating regularly, which also affects your blood sugar, according to the Centers for Disease Control and Prevention.

If you’re diagnosed with flu, it’s very important to check blood sugar readings several times a day. Feeling tired from the flu can mask symptoms of low blood glucose and high blood glucose.

How do flu vaccines work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination.  These antibodies provide protection against infection with the viruses that are in the vaccine.

The seasonal flu vaccine protects against the influenza virus that research indicates will be most common during the upcoming season.  Three kinds of influenza commonly circulate among people today:  influenza B viruses, influenza A (H1N1) viruses, and influenza A (H3N2) viruses.  The viruses in the vaccine can change each year based on international surveillance and scientists’ estimations about which types and strains of viruses will circulate in a given year.  Each year, one flu virus of each kind is used to produce seasonal influenza vaccine.

About 2 weeks after vaccination, antibodies that provide protection against the flu viruses in the vaccine develop in the body.

What kinds of vaccines are available?

There are two types of vaccines:

• The “flu shot” – an inactivated vaccines (containing killed virus) that is given with a needle, usually in the arm.
• The nasal spray flu vaccine – a vaccine made with live, weakened flu viruses that is given as a nasal spray (sometimes called LAIV for “Live Attenuated Influenza Vaccine.” The nasal spray is NOT safe for people with diabetes.

Who Should Get Vaccinated?

Everyone who is at least 6 months of age should get a flu vaccine this season. It’s especially important for some people to get vaccinated. They include people who are at high risk of developing serious complications like pneumonia if they get sick with the flu.  These include people like:

• Those who have certain medical conditions including asthma, diabetes and chronic lung disease;
• Pregnant women;
• People 65 and older;
• Those who live with or care for others who are at high risk.

People with diabetes (type 1 and 2), even when well-managed, are at increased risk of severe disease and complications, like hospitalization and even death, as a result of getting the flu. This is because diabetes can make the immune system less able to fight severe influenza disease. In addition, illness can raise your blood sugar level. Also, sometimes people don’t feel like eating when they are sick, and this can cause blood sugar levels to rise and fall.

CDC recommends that people with either type 1 or type 2 diabetes, who are 6 months and older, get a flu shot. (The nasal spray vaccine should not be given to people with diabetes.)

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. A pneumonia vaccine should be part of a diabetes management plan.

When Should I Get Vaccinated?

The CDC recommends that people get vaccinated against influenza as soon as the flu season becomes available in their community. The season is unpredictable, so you are better protected if you get the vaccine as early as possible.  If you have a cold or other respiratory illness, wait until you are healthy again before having your flu shot. And don’t get a flu shot if you are allergic to eggs.

It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza.  In the  meantime, you are still at risk for getting the flu and should take the typical precautions.

You are advised to continue to take the general precautions of preventing seasonal flu and other communicable diseases:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose, or mouth. Germs spread that way. Try to avoid close contact with sick people.
• If you get sick, stay home from work or school and limit contact with others to keep from infecting them.

What if you do get sick?  5 Things You Need to Know if You Have Diabetes

Since you can still get sick even if you do get vaccinated—albeit usually with a milder form of the illness—here are five other things diabetics should keep in mind if they get the seasonal flu or H1N1:

1. Check the label before taking any over-the-counter medication. Some OTC medicines, particularly cough syrups, contain sugar, which can affect blood glucose levels. It’s okay that a diabetic takes OTC medications, but whether they’re sick or not, they should always be aware of the sugar content. The pharmacist can recommend medicine that has low sugar content or none at all.
2. Stay hydrated and eat regularly. When you’re sick, it’s important to drink extra calorie-free liquids and to try to eat regularly, according to the CDC. If your stomach is upset, try to consume soft foods or drinks that contain similar carbohydrate levels as you’d normally take in. And if you’re not able to do this, talk to your doctor about adjusting your diabetes medication. If you have the flu and can’t keep food down, that can affect the amount of medication that you should take; too much or too little can send blood sugar levels spiraling too high or too low, Johnson says.
3. Know when it’s time to call the doctor. Diabetics who are too sick to eat or keep food down for more than six hours should call the doctor or go to the emergency room, the CDC advises. The same goes for those who are having trouble breathing or who have severe diarrhea, lose 5 pounds or more, have a temperature over 101 degrees, or have a blood glucose level lower than 60 mg/dL or over 300 mg/dL. And any signs of confusion or excessive sleepiness should prompt an immediate visit to a doctor’s office or emergency room.
4. Weigh yourself daily. Weight loss without effort can be a sign of blood sugar that is too high.
5. Don’t forget about the routine recommendations to reduce the spread of illness. Cover your nose and mouth with a tissue when you sneeze or cough and throw the tissue away. Wash your hands with soap and water; keep hand sanitizer close (and use it); and try not to touch your nose, eyes, or mouth to reduce the spread of germs. Finally, if you do get sick, stay home to avoid spreading germs to others.