Cold and flu more serious in diabetics
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Flu season is unpleasant for everyone, but if you have diabetes it can be even worse. If diabetics fail to manage their disease while sick, the complications can be serious, the American Diabetes Association warned in a statement this week.
“Your average person (with the flu) will spend three or four days at home but they’ll do okay,” said Dr. John Buse, president of medicine and science at the ADA. “In patients with diabetes, occasionally they even have to be hospitalized.”
When a person has an infection, the physiologic stress on the body can cause their blood sugar to rise, Buse said. This is of particular concern to diabetics, who must monitor their blood sugar because levels that are either too high or too low can be dangerous. The body burns stored fat for energy when there is no food available, and if insulin is not taken regularly, particularly in type 1 diabetics, a waste product called ketones can begin to build up, he said. High ketone levels can lead to ketoacidosis, which can result in a coma or death.
As well, some drugstore medications, commonly taken to alleviate cold and flu symptoms, may pose a risk to diabetics also dealing with blood pressure, Buse said. Cough syrups containing decongestants can raise blood sugar and blood pressure, and hypertension is an issue for about half of diabetics. Though they may relieve some symptoms, these medications haven’t been demonstrated to actually reduce the duration of colds or flu, he said.
“It’s not that nobody with diabetes can take these products,” Buse said. “As a rule of thumb, if people don’t know that it’s okay to take it, it’s probably better to err on the side of not taking it.” It is generally better to put something on the area that is bothering you instead of ingesting something that has to work through your entire body, he suggested - for example, choose a nasal spray to relieve a stuffy nose instead of an oral decongestant.
Diabetics who become ill this winter can avoid more serious complications by taking extra care to manage their condition, Buse said. Unless a doctor advises otherwise, diabetics should continue to take their medication as usual, even if they are not eating normally, he said.
While they are sick, patients should eat as much as is comfortable for them, Buse said—the ADA recommends 15 grams of carbohydrates per hour—but this may be difficult during some illnesses. Nevertheless, liquids are key to preventing dehydration, and water, tea and broth are better choices than sugar-laden juices, which can raise blood sugar.
In addition to monitoring their blood sugar regularly for dangerous rises or drops, the ADA also suggests monitoring urine for ketones, the end-product of excessive fatty-acid breakdown. Ketones are found in the urine when the ketones in the blood surpass a certain level.
If blood sugar levels are too low, drinking juice with about 15 grams of carbohydrates once an hour, or a 1/2 cup of apple juice or one cup of milk, can help.
The ADA advises diabetics to contact their doctor if ketones rise or are present in the urine for more than 12 hours; if vomiting or diarrhea lasts for more than six hours; if a fever increases or lasts longer than a day; if there is abdominal pain or if blood sugar can’t be controlled.
Because it can be hard to reach a health care professional quickly, it’s helpful for diabetics to have a plan in place with their doctors, Buse said. “The thing to do is to know what to do before you get sick.”
It is also recommended that diabetics receive the influenza vaccine every year, Buse said. Pneumonia isn’t a winter-specific illness, he said, but diabetics should be vaccinated against that as well - once before age 65, and once after.
Hand-washing is the best known weapon for cold and flu prevention, Buse said, but if you get sick, taking care to monitor your diabetes can help you get over it quickly and without complication.
“The bottom line is there’s just more consequences to colds, potentially, in patients with diabetes than in the general population.”
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