Diabetes And Influenza: A Dangerous Combination

Nov. 14, 2017 is World Diabetes Day, the world’s largest diabetes awareness campaign that aims to unite the global diabetes community to produce a powerful voice to highlight the realities and threats of dealing with this chronic medical condition.

Diabetes is a major threat to health globally.

In the U.S., diabetes rates have almost doubled in the past two decades, from 5.5 percent in 1994 to 9.3 percent in 2012. An estimated 30.3 million people, or 9.4 percent of the U.S. population, had diabetes in 2015. The CDC projects that one in three adults could have diabetes by 2050. More than one-quarter of seniors (ages 65 and older) has diabetes (25.9 percent, or 11 million seniors). In the European region, about 60 million people have diabetes, or about 10.3 percent of men and 9.6 percent of women aged 25 years and over. In Africa, the rate of diabetes remains low, but the number of people living with diabetes has dramatically increased from 4 million in 1980 to 25 million in 2014. More than 60 percent of those with diabetes live in Asia, with nearly half in China and India combined. The Asia Pacific region has 138 million people with diabetes, and the number may increase to 201 million by 2035.

The prevalence of diabetes is increasing mostly due to increases in obesity, unhealthy eating habits and decreased physical inactivity. Globally, diabetes kills about 3.4 million people annually. WHO projects that diabetes deaths will double between 2005 and 2030.

Diabetes itself is not a major problem unless the blood glucose is uncontrolled and either rises too high or drops too low. If diabetes is not managed correctly (meaning blood glucose is not properly regulated), sufferers are likely to become progressively sick and debilitated. Over time, diabetes can damage the heart, blood vessels, kidneys, eyes and nerves. For diabetics, maintaining blood sugar levels in a normal range – not too high or too low – is a lifelong challenge. Half of people with diabetes die of cardiovascular disease (primarily heart disease and stroke), and 10-20 percent of people with diabetes die of kidney failure. Diabetes is also a major cause of blindness and lower limb amputation.

The flu can complicate diabetes.

Influenza is highly contagious, as the viruses are spread when an infected person coughs or sneezes small virus-containing droplets into the air. Influenza is a serious threat to people with all types of diabetes. People with diabetes are twice as likely to die from heart disease or stroke as people without diabetes and six times more likely to be hospitalized. People with diabetes are generally at a greater risk if they catch the flu, as it can pose significant difficulties with diabetes management.

Flu infection can cause changes in the blood sugar and prevent people with diabetes from eating properly, which further affects blood glucose. Moreover, diabetes can make the immune system less able to fight infections. Diabetes patients with flu face very serious health risks such as ketoacidosis (condition when the body cannot use sugar as a fuel source because there is no insulin or not enough insulin) and Hyperosmolar Hyperglycaemic State (HHS).

Vaccination is the best protection during the flu season.

Flu season occurs during the cold half of the year in each hemisphere. The CDC recommends that all people who are six months and older get a flu vaccine. Flu shots are approved for use in people with diabetes and other health conditions. People who work with or live with diabetics should also be immunized to avoid spreading the flu. The flu shot has a long, established safety record in people with diabetes. A dangerous complication of the flu is pneumonia and diabetics are also at increased risk of developing pneumococcal pneumonia because of the flu, so the pneumococcal vaccination is also recommended. In addition to getting the flu vaccine and the pneumococcal vaccine, people with diabetes should take everyday precautions for protecting against the flu.

What to do when you have diabetes and the flu.

Diabetics who get the flu should ask their doctors about prescription antiviral medications that can ease symptoms and shorten the duration of the illness. For best results, antivirals should be taken within 48 hours of the onset of flu symptoms. Over-the-counter medications can help patients feel better; however, they do not lessen flu infection or its consequences. It is also important to check blood glucose levels every two to four hours and record the readings. The doctor should be notified if the blood sugar remains high or gets too low. People with Type 1 diabetes who feel sick and have a blood glucose level over 250 mg/dl should test for ketones in the urine. If left untreated, excessive ketones can result in ketoacidosis. Diabetics who are sick often think they should not take their medications because it will cause their blood glucose to go low. However, this is not the case – because of the presence of stress hormones, they need their usual medicine and may sometimes even need more. Furthermore, it is also important for people with diabetes to avoid dehydration.

You can find more information on diabetes and the flu at www.cdc.gov/diabetes/flu.