Why People With Diabetes Need a Flu Shot

With a weakened immune system, every protection counts

If you have any form of diabetes, even if it’s well-controlled, I strongly recommend you get the flu vaccine.  

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Here’s why. Everyone has the chance to get the flu. If you have diabetes, your immune system is already weakened.  Taking extra precautions is important because your overall risk for catching the flu is higher than those who don’t have it.

For the same reason, you are also more likely to have complications from the flu.

Even more fundamentally, if you have diabetes, it is so important that you take active steps to keep it under control. This can help protect you from a range of more serious health problems, including those that can all spiral from the flu.

A few exceptions apply.  You should not get a flu vaccine if you have ever had an allergic reaction to the flu vaccine in the past, if you are allergic to eggs or if you currently have symptoms of flu or common cold.

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Why inadequately controlled diabetes heightens risk

Uncontrolled or less controlled diabetes and flu do not play well together. Here’s how this duo can affect your health:

  • The immune system of people with uncontrolled or less controlled diabetes is weakened. For this reason, they are more likely to develop complications of flu – even potentially life-threatening conditions, such as bacterial pneumonia.
  • The risk of pneumonia in people with diabetes is even greater if they have other chronic conditions, including chronic kidney disease and chronic obstructive pulmonary disease (COPD).
  • Flu and infections can worsen blood glucose control and exacerbate diabetes symptoms, particularly in people whose diabetes is less controlled. This can lead to more serious conditions.
  • Glucose control could become even worse or more difficult to treat if treatment with steroids (such as prednisone) is needed for the management of pneumonia, bronchitis and/or COPD.
  • Those with uncontrolled diabetes can also develop severely high blood sugars, which can lead to a hyperglycemic state or diabetic ketoacidosis, both of which require hospitalization — and often an admission to the intensive care unit.
  • Other problems may occur even after the flu is gone. Worsening glucose control might last beyond the duration of the flu. So even after managing high glucose levels during your illness, you may need to readjust your diabetes regimen. When you add new — and sometimes costly — diabetes medications to manage blood sugars, you may develop new side effects as well.

Even if you are at low risk for complications from flu, preventing it is crucial to avoid its unpleasant symptoms, worsening of your blood sugars or spreading the illness to others.

The best flu treatment is prevention

Getting a flu shot is the single intervention that can keep you healthier during flu season. We don’t recommend the nasal spray vaccine for people with diabetes.

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Along with the vaccination, protect yourself with common sense precautions. While it’s impossible to be in a completely sterile environment, it’s crucial to:

  • Wash your hands with soap and water, especially after coughing or sneezing
  • Don’t touch your eyes, nose and mouth, which can spread germs
  • Avoid close contact with those you know are sick
  • Cover your mouth and nose with a tissue if you’re coughing or sneezing, and throw the tissue out after you use it

More information

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Marwan Hamaty, MD

Marwan Hamaty, MD, MBA, is a staff physician in the Endocrinology & Metabolism Institute. His specialties are diabetes and pre-diabetes.
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