October 1, 2020

Why People With Diabetes Need a Flu Shot

With a weakened immune system, every protection counts

woman getting flu shot

If you have any form of diabetes, even if it’s well-controlled, it’s strongly recommended that you get a flu vaccine. Here’s why: Anyone can get the flu, and diabetes weakens the immune system.


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“Taking extra precautions is important because, with diabetes, the overall risk for catching the flu and having complications from it is higher than for those who don’t have diabetes,” says endocrinologist Marwan Hamaty, MD.

“Nowadays, because of the COVID-19 pandemic, having the flu vaccine is more important than ever. Getting sick with a flu could weaken the immune system further and make you at even higher risks for COVID-19 infections and its complications,” he adds.

What’s more, 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.
  • If you currently have symptoms of the flu or a common cold.

Why inadequately controlled diabetes heightens risk

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 can become even more difficult to treat if you need treatment with steroids (such as prednisone) for managing 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.

Other problems may occur even after the flu is gone. “Worsening glucose control might last longer than your bout of the flu,” Dr. Hamaty says. “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,” he says.

Even if you’re at low risk for complications from the 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,” Dr. Hamaty says. “We don’t recommend the nasal spray vaccine for people with diabetes.”

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 follow these simple steps to stay healthy, especially in the age of COVID-19:

  • 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 anyone you know who is sick.
  • Cover your mouth and nose with a tissue if you’re coughing or sneezing, and throw the tissue out after you use it.

One good thing about COVID-19: Social distancing practiced for the prevention of COVID-19 will help reducing the spread of flu.

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