It’s back. The start of the flu season, and that leaves people with a decision about whether to get this year’s vaccine.
For people with diabetes, that question is even more crucial.
People with type 1 or type 2 diabetes have an increased risk of contracting seasonal viruses, such as the flu, and being hospitalized while fighting the disease.
For those struggling with obesity, as many people with diabetes do, infections such as whooping cough or the flu are especially dangerous.
For example, a virus that might produce a mild illness in a lean person could tip an obese person with restrictive lung physiology into overt respiratory failure.
“Pertussis — or any respiratory illness — could be worse for severely obese people who may have comorbidities such as sleep apnea and obesity hypoventilation syndrome,” Dr. Eric Sodicoff, author of the Phoenixville Nutrition Guide, told Healthline.
The American Association of Diabetes Educators (AADE) emphasizes that no matter how well-managed your diabetes may be, every eligible person with diabetes should get vaccinated.
“People with diabetes may be at higher risk of getting certain diseases and also serious problems from diseases that could’ve been prevented with vaccines,” Evan Sisson, PharmD, MHA, CDE, FAADE, and associate professor in the Department of Pharmacotherapy & Outcomes Science at Virginia Commonwealth’ University’s School of Pharmacy, told Healthline. “Everyone should know what vaccines they need to protect themselves and discuss with their doctor whether they are up to date with the vaccines.”
Experts say vaccines, such as the flu shot, will most likely not give you the illness they are designed to prevent because they contain a dead version of the virus.
Instead, the vaccines help your immune system prepare the antibodies that will fight off the virus if you come into contact with it.
Why diabetes puts you at higher risk
Since type 1 diabetes is an autoimmune disease, the immune system of someone with the ailment has already been compromised, which means its ability to successfully fight off a virus is less likely.
“People with type I diabetes have immune systems that are less vigilant than in normal people,” Dr. Len Horovitz, a pulmonary specialist from Lenox Hill Hospital in New York City, told Healthline. “The infection risk in diabetes, whether viral or bacterial, is well known,” Horovitz explained. “In addition, high blood sugar levels [in type 1 or type 2 diabetes] promote infection on their own.”
Horovitz adds that people with diabetes are also more susceptible to pneumococcal pneumonia, increasing the value of vaccines such as Prevnar and Pneumovax.
For patients specifically with type 1 diabetes, a simple bout of vomiting, fever and/or virus-induced dehydration can easily lead to diabetic ketoacidosis (DKA).
DKA, according to the CDC, is “an emergency condition in which extremely high blood glucose levels, along with a severe lack of insulin, result in the breakdown of body fat for energy, and an accumulation of ketones in the blood and urine. Signs of DKA are nausea and vomiting, stomach pain, fruity breath odor, and rapid breathing. Untreated DKA can lead to coma and death.”
Even with previously well-managed blood sugar levels, the addition of the flu virus within a body of a person with type 1 diabetes exacerbates its ability to manage even basic aspects of homeostasis.
A person with type 1 diabetes who is concerned they may have the flu should monitor blood sugar levels with extra diligence. They should get to an emergency room quickly to receive intravenous fluids (saline, electrolytes, and sometimes insulin and glucose) if blood sugars seem resistant to insulin doses, at the first sign of vomiting, and if ketone levels on urine or blood test-strips become moderate to large.
People with type 1 and type 2 diabetes are also twice as likely to die of a complication related to the flu, according to a 2018 study from the Indian Journal of Endocrinology and Metabolism.