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Beware of flu if you’re a diabetic

By DR. GRACE CAROLE BELTRAN, The Philippine STAR Published Jan 24, 2023 5:00 am

You should not take the flu for granted. That is what I learned this 2023. I’ve had flu in the past but I never took it seriously since I always managed it smoothly, and without much trouble.

But before the year 2022 ended, I was down with the flu and lost my appetite for the first time. And that got me really worried. Growing up, I never had problems with my appetite when I got sick. In fact, I was always hungry and ate a lot because my mom would buy my favorite food.

But this one was different. I also had a high fever for three days with an itchy throat, I felt weak, and had a hacking cough. I had my antigen test but it turned out negative. Then the worst thing happened. I infected my husband. When someone with diabetes gets the flu, one should really be alarmed. And that’s the reason behind this article.

I read somewhere that for people with diabetes, serious flu-related complications may include “worsening of diabetes, permanent physical decline and loss of independence, hospitalization, even death.”

When someone with diabetes gets the flu, serious flu-related complications may arise.

Another article says that one of the top health risks for diabetes is influenza and its ever-fluctuating flu viruses. Dehydration, a change in eating schedule, and how the body responds to infection can all make the management of blood sugar more difficult.

Diabetes weakens the body’s immune system, so contracting the flu makes fighting the respiratory virus even more demanding. When influenza infects a diabetic, blood glucose levels rise in response. If people aren’t feeling well enough to eat as they normally would, it can make it harder to control or manage their blood sugar.

When you are sick, your body manufactures its own additional glucose to provide energy to fight the infection. The flu may also cause the body to release the stress hormones adrenaline or cortisol, which reduce the effectiveness of insulin, the hormone responsible for lowering blood glucose levels. This may result in high glucose levels that are very difficult to bring back to normal levels.

As a diabetic, catching illnesses early on will allow you to care for yourself properly and reduce the risk of any complications.

With insulin levels low, your body can’t effectively use the glucose circulating through it. Instead, it turns to using ketones for energy. The combination of ketones and high glucose levels can make your body too acidic to function properly. This is called diabetic ketoacidosis.

Diabetic ketoacidosis (DKA) is a serious complication of diabetes that can be life-threatening. DKA is most common among people with type 1 diabetes. But people with type 2 diabetes can also develop DKA. DKA develops when your body doesn’t have enough insulin to allow blood sugar into your cells for use as energy. Instead, your liver breaks down fat for fuel, a process that produces acids called ketones. When too many ketones are produced too fast, they can build up to dangerous levels in your body. DKA can lead to diabetic coma or even death.

If these same patients have fever, that actually increases the likelihood of becoming dehydrated, which limits the ability of the body all the more to control blood glucose by flushing it in the urine. If the blood sugar becomes over 250 mg/dl, then the body will be more resistant to one’s own insulin or the insulin you are taking by injection, which is a very serious concern. The flu virus infects cells at the back of the nose and throat, causing congestion or sore throat. Inflammation of the mucus membranes creates an opportunity for bacteria that are normally present in our throats to infect the lungs and can lead to pneumonia. Luckily my husband was spared this serious infection that can make it harder to control blood sugar, which again can lead to diabetic ketoacidosis.

Know the symptoms

Most important is to make sure that you know all the possible signs and symptoms of the flu. As a diabetic, catching illnesses early on will allow you to care for yourself properly and reduce the risk of any complications. Some of the main symptoms of the flu include a cough, sore throat, runny nose, body aches, headaches, chills, and fatigue. You may show one or more of the symptoms at any given time, so don’t write it off if you feel a little under the weather. Monitor your body and symptoms and if you notice things getting worse, contact your doctor.

In some cases of the flu, people experience nausea and vomiting as well. Other symptoms of severe cases of the flu include seizures, a fever higher than 104 degrees Fahrenheit, chest pain, severe weakness, or worsening of chronic medical conditions. Also, get an RT-PCR test to make sure it’s not COVID-19.

Monitor fluid and food intake
Avoid drinking things that are laden with excess sugar, especially if you don’t normally drink them in your diabetic management routine.

If you’re experiencing any one of the symptoms of the flu, start to monitor your food and fluid intake. While you likely won’t feel hungry or thirsty, eating and drinking are important to help keep you hydrated and maintain stable blood sugar levels. Try to at least eat a few easily digestible carbohydrates and drink enough water. Eat what you usually eat for your meal plans and consume at least 15 grams of carbohydrates every hour or so to keep your blood sugar levels stabilized. If you feel too sick to eat or drink, contact your doctor immediately.

Staying hydrated is also important to help your immune system work efficiently and avoid any complications. Avoid drinking things that are laden with excess sugar, especially if you don’t normally drink them in your diabetic management routine. Instead, opt for plain water, tea, or sugar-free ginger ale to help soothe upset stomach. Try to drink at least one cup of liquids every hour.

Regularly check your blood sugar
If you feel sick, even if you’re not sick with the flu, check your blood sugar every three to four hours at the very minimum.

In addition to monitoring your fluid and food intake, you need to check your blood sugar frequently—much more than usual. If you feel sick, even if you’re not sick with the flu, check your blood sugar every three to four hours at the very minimum. If you notice any severe change, call your doctor to discuss adjusting your insulin levels.

Monitor your weight
Since flu symptoms can mask the signs of high blood glucose, keeping track of your weight will give you some added input. If you notice a significant decrease in your weight over a few days, it could be a sign that you’ve been in an elongated state of high blood sugar and you need to adjust your medications.

Another thing you should add to your diabetic management plan if you have the flu is your weight management. Since flu symptoms can mask the signs of high blood glucose, keeping track of your weight will give you some added input. If you notice a significant decrease in your weight over a few days, especially if you’re still able to eat and drink regularly, it could be a sign that you’ve been in an elongated state of high blood sugar and you need to adjust your medications.

Check labels thoroughly

If you need to take any over-the-counter medications, always talk to your doctor or pharmacist and read the labels thoroughly before taking them. Certain OTC medications contain high levels of sugar that can cause problems with your blood sugar levels.

Get vaccinated
The most sophisticated tool for fighting the flu is immunization. 

The most sophisticated tool for fighting the flu is immunization. The best time to get the vaccine for influenza is before the start of the flu season. In the Philippines, the flu season coincides with the rainy season. It is best to get the vaccine between February and June. You may still get the vaccine outside these months, though. You must get a flu shot every year to be protected from the latest strain of the virus in a particular flu season.