H1N1 (Swine Flu) and Diabetes
Diabetes and the H1N1 Virus
Diabetes puts people at increased risk for developing complications from the flu, both seasonal and H1N1, such as hospitalization and death. The flu may interfere with efforts to control blood sugar levels, putting those with diabetes at increased risk of high or low blood sugar if they get sick with the flu.
There are several steps that people with diabetes should take to fight against H1N1 flu this season. CDC recommends that all people with all types of diabetes who are 6 months through 64 years of age get vaccinated with the H1N1 flu shot. As supplies of the H1N1 vaccine increase, people 65 years of age and older also should get the H1N1 vaccine. All people with diabetes who are 6 months of age and older, including people 65 years of age and older, should get the vaccine "shot" for seasonal flu. They should not get the get the nasal spray vaccine. People with diabetes also should talk with their health care provider about getting a pneumonia (pneumococcal) vaccine as part of their diabetes management plan.
Get Treatment Early
People with diabetes who are suspected to have influenza (either seasonal or H1N1) should receive antiviral treatment. Health care providers are reminded that they should not wait for the lab results, if testing is done, to confirm the type of influenza before prescribing influenza antiviral medications. Antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza) can both be taken by people with diabetes. Antiviral drugs are most beneficial when started in the first 48 hours after illness onset, but should also be given even after 48 hours to people who are not improving, especially those with a high risk condition like diabetes and those who are very sick (for example people who are in the hospital).
Make a Plan for the Flu
In addition to getting vaccinated, people with diabetes should also take everyday precautions to protect against the flu, such as frequent hand washing. People with diabetes should also make a plan with their healthcare provider for what they should do in case they get sick. Sick day guidelines for people with diabetes include the following:
- Take your usual dose of pills or insulin as close as possible to the same time as usual. Your health care provider may need to change dose of medication as needed.
- Monitor your blood sugar closely.
- If you can't eat your usual diet, eat enough soft foods or drink enough liquids to take the place of the fruits and starchy foods you usually eat.
- Drink extra calorie-free liquids, like water, diet soda or tea, 4-6 ounces every hour in small sips.
As with any illness in someone with diabetes,
- Check your temperature in the morning and evening. If your temperature is over 101° F, call your health care provider for advice.
- Check you urine for ketones. If you have moderate or large amounts of ketones in your urine and your blood glucose is 250mg/dl or higher, call your health care provider or go to an emergency room.
Take Everyday Precautions
For everyone, good health habits like covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like the flu. Take these everyday steps to protect your health:
- Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
- Avoid touching your eyes, nose and mouth. Germs spread that way.
If you do get sick:
- Stay home if you get sick, except to receive medical care or other necessities. You should not return to work or school until your fever has been gone for at least 24 hours without the use of fever reducing medications.
- Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
The Dangers of Diabetes and H1N1
Influenza is unpredictable, but scientists believe that the H1N1 flu virus will cause more illness, hospital stays, and deaths in the United States during the coming months. Approximately 70% of persons hospitalized from H1N1 influenza have had a recognized high risk condition (approximately 60% of children and approximately 80% among adults). These high risk conditions are the same conditions that increase the risk of complications from seasonal influenza infection and include people who have a metabolic disorder such as diabetes.
- Complications of flu include worsening of chronic medical conditions such as diabetes. Persons with diabetes may have abnormal immune function that can lead to increased risk of complications from influenza infection. Influenza may also interfere with blood glucose management.
- People with diabetes are six times more likely to be hospitalized with seasonal influenza complications and almost three times more likely to die.
Excerpted and adapted from http://www.cdc.gov/diabetes/news/docs/flu.htm. Visit the CDC's site for all the latest swine flu information.
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