Many people don’t realize that diabetes comes with a much higher risk of serious flu complications. Why? Because diabetes impairs the functioning of your immune system, so you will have a harder time fighting off colds and flu viruses. The longer the virus stays in your body, the more likely it is that you will develop serious complications. Fortunately, there are several steps you can take to manage a cold or flu if you have diabetes.

1. Keep taking your medication
For some reason, diabetes patients sometimes think they can skip their insulin, metformin or any other medication because they don't eat as much when they are ill. This, however, could not be more wrong. People need to keep taking their medication because while you may not be eating as much, you are also not getting any physical activity to help offset the high blood sugar levels. Furthermore, having an infection itself can lead to high blood sugar levels. Therefore, keep taking your medication while you fight off the infection.
2. Eat your meals regularly
You may not want to eat when you have the cold or flu, but you should try to get between 45 and 50 grams of carbohydrates every three to four hours to keep your blood sugar levels in the appropriate range. If you are really having trouble eating, you may have better luck with soup, popsicles, crackers, or gelatin as they are easier to keep down.
3. Stay well hydrated
Diabetics, in general, experience frequent urination, so they are already at risk of becoming dehydrated. Patients with the flu are also prone to dehydration. If you have both diabetes and the flu, you should take special care to get the fluids you need. You should be drinking about eight ounces of water or another zero-calorie fluid every hour. If you can’t keep any food down, alternate drinking zero-calorie fluid with carb-containing fluids (such as juice or soda) every other hour.
4. Check your blood sugar levels regularly
When you are sick, you might miss the symptoms of high blood sugar levels since you feel bad anyway. This can be dangerous as you can miss any fluctuations in your blood sugar levels Therefore, for the first couple of days you are sick, check your blood sugar levels every two to four hours. If you blood sugar levels appear normal, you don’t have do extra checking. However, if they are higher or lower than normal, you should adjust your carbohydrate consumption accordingly. If you keep seeing a spike in your blood sugar levels, talk to your doctor.
5. Avoid taking cold medicine that is high in sugar
6. Look at the ingredient list for any medication you buy
Both active and inactive ingredients are listed on over-the-counter medications. Active ingredients are those that actively work to reduce your symptoms, while inactive ingredients don’t have any medicinal value. Under inactive ingredients, if you see sugar or alcohol listed, try to avoid taking those medications because both of these can cause your blood glucose levels to rise.
Under active ingredients, be on the look-out for the following:
- Many cold medications that contain acetaminophen (Tylenol, paracetamol) can be dangerous for your liver and kidneys. Since many people with diabetes have kidney disease, consult with your doctor before using medications that contain acetaminophen.
- Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used in cold and flu medications. NSAIDs can be dangerous to people with heart disease or stroke, which is highly prevalent in diabetes patients. Examples of common NSAIDs to avoid include naproxen and ibuprofen, both which can also lead to kidney and liver disease if you take them a lot. Thus, consult your doctor before taking medication with NSAIDs.
- Dextromethorphan is found in many cough medications and is appropriate for patients with diabetes at certain dosages. Talk to your doctor.
- Guaifenesin is in some cough medications and can be used by diabetics.
- Decongestants can reduce the effects of insulin or other diabetes medications. They can also increase blood pressure. Talk to your doctor about which decongestants are best for diabetics.
7. Be on high alert for any potential complications
You should call a doctor if you find yourself with any of the following:
- Two or more consecutive blood sugar readings that are indicative of high, uncontrolled blood sugar.
- Uncontrollable nausea or vomiting.
- Uncontrollable diarrhea.
- An inability to keep any fluids down.
- A consistent fever for more than 24 hours.
- Belly pain.
- Valdez, R., Narayan, K. M., Geiss, L. S., & Engelgau, M. M. (1999). Impact of diabetes mellitus on mortality associated with pneumonia and influenza among non-Hispanic black and white US adults. American Journal of Public Health, 89(11), 1715-1721.
- Allard, R., Leclerc, P., Tremblay, C., & Tannenbaum, T. N. (2010). Diabetes and the severity of pandemic influenza A (H1N1) infection. Diabetes care, 33(7), 1491-1493.
- Stiver, G. (2003). The treatment of influenza with antiviral drugs. Cmaj, 168(1), 49-57.
- Photo courtesy of SteadyHealth
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