Diabetes and the Flu: 6 Things You Should Know

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, says Debby Johnson, a diabetes educator and nutrition coach with Fit4D, an online personalized fitness and nutritional coaching service for people with diabetes. "Feeling tired from the flu can mask symptoms of low blood glucose and high blood glucose," she warns.

Diabetics' immune systems are more susceptible to severe cases of the flu, so you may get very sick or even have to be hospitalized, reports the CDC. The agency recommends that all diabetics get a seasonal flu shot between October and mid-November. As for the H1N1 vaccine, expected to be available soon, everyone between the ages of 6 months and 24 years—regardless of pre-existing medical conditions—should get the shot. People ages 25 through 64 who have diabetes or other medical conditions tied to a higher risk of complications from the flu also should be vaccinated, health officials say.

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:

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," says Marc Wolf, a pharmacist and CEO of Diabetic Care Services Inc., a Cleveland-based company that sells diabetes testing supplies. "The pharmacist can recommend medicine that has low sugar content or none at all."

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.

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, Wolf says.

Weigh yourself daily. Weight loss without effort can be a sign of blood sugar that is too high.

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.