The flu (influenza) this year is prevalent and dangerous. So much so that the Centers for Disease Control and Prevention (CDC) have declared it an epidemic. (1) The flu is very contagious and is caused by a virus that infects the respiratory tract (including the nose, throat and lungs) by inhaling droplets released with a cough or a sneeze from an infected person.(2,3) These viruses can also live on hard surfaces for a period of 2-8 hours. (4) It can be passed to another person up to a few days before symptoms occur in an individual. (5) People with diabetes can have particularly hard times with the flu.

what to do when you have the flu with diabetesIt is scary to see how extensive the flu is this year. It is affecting every region in the United States. The CDC publishes a weekly map that shows influenza activity weekly by state and territory. As you can see by looking at the map, it is very widespread. I know personally that it hits hard. I am trying to win my battle with the flu that I came down with about a week ago. I was pro-active and had my yearly flu shot, but with caring for my two year old ill grandson, I was destined to get it. Even though I had the vaccine, washed my hands often and came down with the flu, I still recommend that if you do not have the flu and you did not get the flu shot yet, talk to your doctor to see if you should have one. Experts predict it is likely the strains of this year’s flu will change and match up with the protection that is acquired from this year’s vaccine. (1)

Remember that the flu is dangerous and can be deadly. Children, frail elderly and people with weakened immune systems (which can include people with diabetes) are some of the people at high risk of complications from the flu. (6,7)

What are the symptoms of the flu?

As the flu is a viral infection of the respiratory tract, symptoms include a general achy feeling with cold-like symptoms. Coughing, sneezing, sore throat, and congestion (stuffiness or runny nose) are usually part of the picture. An increase in body temperature or fever may occur or chills even without a fever is common. Feeling fatigued, drained and needing bed-rest are other symptoms. In some cases, especially in children the person may also vomit and/or have diarrhea. (2) 

What are some complications from the flu?

Complications include diseases of the airways such as pneumonia, bronchitis and sinus infections. Ear infections can also occur. Other health conditions such as asthma and heart problems may worsen. Some of these problems may need to be treated in the hospital. (8)

Rare but troublesome complications include tonsillitis, meningitis and encephalitis. (3) A precaution you can take to avoid pneumonia is to get the pneumococcal vaccine. (5) 

What should you do if you start having symptoms of the flu?

It is important to contact your doctor or healthcare team immediately. The American Lung Association recommends you do this to give your doctor the opportunity to order an antiviral medication like:

  • Oseltamivir (Tamiflu®)
  • Zanamivir (Relenza®)

These medications work best when taken within 2 days of feeling flu symptoms.  These medication can reduce the severity and length of time you will suffer with the flu. Your doctor needs to decide if this is right for you. (9)

What else should you ask your doctor?

What other medications should I take to help my flu? All over the counter medications you take should be cleared by your healthcare team.  An example of a medication that is in some cold and flu formulations is Pseudoephedrine. This has been shown to increase blood glucose and also blood pressure. (10) Ask your doctor and pharmacist, for all of your medical conditions, what medications will be safe for you to relieve your symptoms.

Having any illness can increase your blood glucose. Do not stop taking your diabetes medications without talking to your physician as your blood glucose can elevate quickly. Ask your doctor how often you need to test your blood glucose and for what blood glucose measurement you should call back or go to the hospital. The American Diabetes Association recommends people with diabetes check ketone levels every 4-6 hours if they have the flu. Ask your doctor if you should come in for a visit or go to the hospital if your ketone levels are moderate or high.  (11) 

Ask for sick day rules if you do not have them. 

Usually sick day rules contain advice like:

  • Take you diabetes medication as ordered
  • Test your blood glucose according to your physician’s recommendations.
  • Hydrate with low or no carbohydrate containing beverages

Have meals and snacks as tolerated and if this is not possible, have foods or beverages that contain the amount of carbohydrates that are in your food plan. Contact your physician immediately if you can not do this or report to the hospital. 

Take your temperature as requested by your doctor (5,6)

Ask your doctor under what conditions should you go to the hospital. People with diabetes are hospitalized three times as often as people without diabetes from the flu. (5) Ask the amount of time you can go without eating and what temperature is too high to stay at home. Usually if you have trouble breathing, can’t make good decisions or are suffering from nausea or diarrhea you should call 911 or go to the hospital but ask your doctor for any special instructions. (6)

Simple steps to keep others from catching your flu

  1. Cover your mouth with your elbow when you cough or sneeze and then wash your hands with soap and water. If you sneeze or cough into a tissue, throw the tissue away. See the poster from the Minnesota Department of Health
  2. Take care to avoid other people that you can spread the flu to. Do not go out in public when contagious. Do not send your child to school or daycare if your child is sick and call for a sick day if you are ill yourself. (5,12)
  3. Avoid touching your eyes, mouth and nose. If you do, wash your hands with soap and water. (12)

So you can see, the easiest way to deal with the flu is to prevent it. If you get it anyway, call your doctor right away, get instructions and follow the orders of your doctor.  Most people require lots of rest and fluids. Take your medication as ordered and carbohydrates as needed. Hopefully the flu will be a recent memory. Well at least that is what I am hoping for. I know the flu usually lasts between 1-2 weeks. I have a good supply of tissues.

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