The cold-and-flu season is upon us and, let's face it, it's no fun for anyone. But these winter months can be particularly perilous for people with diabetes.
"When you have either type 1 or type 2 diabetes, your immune system is less able to fight infections," explains David Lam, M.D., associate director of the Mount Sinai Diabetes Center in New York City. As a result, you're more likely to get sick—and to suffer complications from what otherwise might be a garden-variety case of the sniffles.
But there are other risks, as well: "When you're sick, your body releases more stress hormones, which in turn can raise blood sugar," adds Lam. That's why it's so important to have a sick plan in place, so that you're better able to manage your blood sugar, stay aware of symptoms, and seek medical attention if necessary. Here's what you need to know to prepare for cold and flu season.
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Getting the influenza vaccine is particularly important for people with diabetes. "If a person with diabetes gets the flu, they are more likely to end up in the hospital with a complication, such as pneumonia, than someone who doesn't have the condition," explains Lam. The flu shot reduces your chances of contracting the disease by anywhere from 40 to 60 percent. Most physicians recommend getting the shot in October, to allow your body at least a couple weeks to develop a protective response to the influenza virus; however, a later vaccination date is still not too late—flu season usually lasts through March. You should also make sure that you get the pneumococcal vaccine, which is recommended for all adults with diabetes. You need two doses, spaced a year apart, for maximum protection.
Regular handwashing can prevent up to 20 percent of all colds, according to the Centers for Disease Control and Prevention. If you don't have access to soap and water, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol. You should also make time for sleep—folks who clock less than six hours a night are over four times as likely to catch a cold, compared to those who get more than seven hours, according to a 2015 study published in the medical journal Sleep.
It's important to have supplies on hand. A sick-day kit should include the following:
• Glucose tablets, in case you feel so sick you can't eat
• Thermometer, to check your temperature
• Acetaminophen to take for fever
• Glucose meter, test strips, lancets, and a lancing device to check your blood sugar levels
• Ketosis test strips (Ketostix), to check your urine for ketones if you have type 1 diabetes
• Glucagon kit for emergency low blood sugar if you have type 1 diabetes
• Extra syringes and insulin, if you take insulin
When you're sick, your body produces stress hormones that make it harder for your body to regulate insulin, says Marvin Lipman, M.D., an endocrinologist in Scarsdale, New York, and former chief medical advisor for Consumer Reports. So be sure to test your blood sugar regularly (generally every two to four hours, but check with your doctor) to make sure it stays as close to normal as possible. If it's rising, your doctor may want you to take a higher dose of your diabetes medication or increase your insulin dose, if you take insulin. If you have type 1 diabetes, check your urine two to three times a day for ketones. And weigh yourself daily: if your weight drops more than a couple pounds, you may be dehydrated and your blood glucose levels could be getting out of control.
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Some over-the-counter cold and flu medications aren't safe to take if you have diabetes. For example, decongestants act like the stress hormone adrenaline on your body, dumping sugar into your bloodstream that can raise your blood sugar levels, explains Lipman. Safe medications include saline nasal sprays, the pain reliever acetaminophen, cough suppressants, such as dextromethorphan, or cough expectorants like guaifenesin. If you're using cough syrups or lozenges, look for ones labeled "sugar free."
You may not feel hungry when you're sick, but it's still important to take in some nutrients, since your body needs fuel and fluids to help you recover. It also helps prevent you from getting dehydrated, which can raise blood sugar. If you feel too crummy to eat your regular diet, try soft foods and liquids instead.
Foods that contain 15 grams of carbs (1 carb serving) include:
• ½ cup fruit juice
• ½ cup regular Jell-O
• six saltine crackers
• ½ cup applesauce
• 1/3 cup noodles or rice.
Try to drink 4 to 6 ounces of calorie-free liquid every hour. Options include water, unsweetened tea, and low-sodium chicken broth.
If you're sick, this is one time in your life when you absolutely shouldn't grit your teeth and bear it.
Some red flags that you need to call your doctor right away include:
• Signs of the flu (high fever, chills, muscle aches, headaches)
• Sudden loss of five or more pounds
• Blood glucose lower than 60 mg/dL or over 250 mg/dL on two checks
• Ketones in your urine
• Trouble breathing