Managing Diabetes Calls for Extra Attention During Flu Season

From uabmedicine.org

Diabetes can weaken the immune system’s ability to fight infection, increasing the risk of serious complications from the influenza virus. However, by paying extra attention to nutrition habits during flu season, most people with diabetes who do catch the flu can avoid serious complications.

People with type 1, type 2, or gestational diabetes are at high risk of serious flu complications, even if they are doing a good job of managing their condition. There is the risk of sinus infections, bronchitis, pneumonia, and other flu-related illnesses. In recent flu seasons, almost 30% of adults in the United States hospitalized with flu had diabetes.

Alabama and many other southern states have high rates of diabetes. Alabama ranks No. 4 in the nation, based on the Behavioural Risk Factor Surveillance System (BRFSS), which collects state data about U.S. residents regarding their health-related risk behaviours. People with diabetes are at a higher risk for catching a contagious illness.

Making Matters Worse

Flu also can make diabetes worse, because some illnesses can make it harder to control blood sugar. Flu may raise sugar levels, but sometimes people don’t feel like eating when they are sick, and a reduced appetite can impact glucose (sugar) levels.

It’s still not clear just how effective certain nutrients, vitamins, anti-oxidants, flavonoids, and other food elements are at boosting immune systems, especially for fighting influenza. In fact, the National Institutes of Health (NIH) says there currently is no strong scientific evidence that any natural product is useful for preventing the flu.

Still, an immune system with greater nutritional resources has a better chance of battling the effects of influenza. That’s especially true for people with diabetes.

Nutrition for Fighting Flu Symptoms
Fever can raise metabolic rates, so the body needs more calories to function normally and support the immune system. A sudden reduction in that caloric intake may cause flu to last longer. However, once flu symptoms are present, appetite may decrease, along with any motivation to prepare even the simplest meal. It’s extremely important to get some nutrients in the system, even when you don’t have an appetite. Beverages are essential because dehydration, a common side effect of the flu, can raise blood sugar.

Anyone with diabetes who is not eating meals because of flu symptoms should at least eat or drink about 50 grams of carbohydrates every four hours, such as 1½ cups of unsweetened applesauce or 1½ cups of fruit juice. Options to avoid dehydration include water, unsweetened tea, and low-sodium chicken broth.

Foods that contain 15 grams of carbs include:

• ½ cup fruit juice

• ½ cup regular Jell-O

• Six saltine crackers

• ½ cup applesauce

• 1/3 cup noodles or rice

People with diabetes can better manage flu season by preparing ahead. It’s a good idea to have enough insulin, other diabetes medicines, and easy-to-fix foods on hand to last several weeks. The supply list below can help you get organized.

Medicines and Supplies

• Milk of magnesia

• Medicine to control diarrhoea

• Antacids

• Pain relievers

• Thermometer

• Suppositories to treat vomiting

Foods 

• Sports drinks

• Juice boxes

• Canned soup

• Regular gelatin

• Regular soft drinks

• Instant cooked cereals

• Crackers

• Instant pudding

• Unsweetened applesauce

This is also a time when comfort foods – and beverages – may help. They can provide sufficient nutrition because, even on the worst flu days, these items may still be appealing enough so that people don’t skip meals or get dehydrated.

See these recipes for diabetes-friendly comfort foods. 

A bowl of soup is a healthy option, keeping in mind to limit carbohydrates to fewer than 15 grams of carbs per serving, and control for sodium, calories, and saturated fat, so that all soup recipes remain diabetes friendly. See these recipes for diabetes-friendly soups.

https://www.uabmedicine.org/-/managing-diabetes-calls-for-extra-attention-during-flu-season

Flu Shots Are More Important Than Ever for People with Diabetes, ASCVD

From managedhealthcareexecutive.com

Flu increases the risk of heart attack, especially among people with diabetes and atherosclerotic cardiovascular disease (ASCVD). COVID-19 and the possibility of co-infection makes getting vaccinated against the flu particularly important this year.

Eat healthier foods, get more exercise, lose weight, take a statin if your LDL cholesterol level is elevated, and take an antihypertensive medication if you have high blood pressure blood — these are some of things that many Americans think about doing to lower their risk of having a heart attack.

The annual flu shot doesn’t make that list but it should. There’s little doubt that getting sick with the flu markedly increases the risk of having a heart attack. Researchers have been collecting evidence on the association between flu and cardiovascular mortality since the 1930s. And the heart attack risk from flu is especially high among people with diabetes and those with atherosclerotic cardiovascular disease (ASCVD).

In an “expert analysis” piece for that was posted yesterday on the American College of Cardiology’s website, Gowtham Grandhi, M.D., M.P.H., Priyanka Bhugra, M.D., and Khurram Nasir, MBBS, FACC, make a convincing case for flu shots being especially important this year for people with diabetes or ASCVD because of the COVID-19 pandemic and the possibility of infection by both viruses. They point to research showing that, in the past, about 1 in 3 individuals with diabetes do not get annual flu shot. They cite other studies showing that the ratio is roughly the same for people with ASCVD.

“Given the suboptimal rates of annual influenza vaccination among DM (diabetes mellitus) and increased risk of co-infection with COVID-19 this influenza, vaccination against influenza among these high-risk individuals is critical until an effective vaccine against COVID-19 is made available and accessible to everyone,” say the trio. It is imperative, they say, to provide flu shots at alternative and non-traditional sites such as grocery stores and parks “to enhance equitable vaccination coverage while maintaining appropriate social distancing and infection control measures.”

Grandhi, Bhugra and Nasir cite a study published in Diabetes Care last month that used data from the Danish disease registry to show that flu shots reduced all-cause mortality, cardiovascular disease mortality, and heart attack and stroke mortality by about 15% among people with diabetes. That translates into number needed to treat of 1,333 to prevent one death. They also reference a 2015 meta-analysis of case-control studies that showed that flu vaccination was associated with a 29% decreased risk of heart attack.

Researchers have come up with various explanations for flu increasing heart attack risk. According to Grandhi, Bhugra and Nasir’s brief account, infection with a flu virus stirs up inflammation that has the effect of destabilizing atherosclerotic plaque so it is more likely to rupture, resulting in an occluded coronary artery.

https://www.managedhealthcareexecutive.com/view/flu-shots-are-more-important-than-ever-for-people-with-diabetes-ascvd

Flu jab and diabetes

From diabetes.org.uk

 Everyone with diabetes – including those who are pregnant – should get their free NHS flu jab to reduce their risk of getting the flu. This is because people with diabetes are more at risk of getting the flu and having diabetes will make it worse.

You can’t get the flu from the flu jab. But it takes two weeks to work – so you could still get the flu during that time. That’s why it’s important to get the jab as soon as you can, ideally during September.

Why you should get the flu jab when you have diabetes

Flu is serious and can make your blood sugar go all over the place. If your blood sugar isn’t within target, the effects of flu can be dragged out and increase your risk of developing serious complications like pneumonia. This puts you at risk of going into hospital. Getting a flu jab will help you avoid this.

A vaccine protects you against the most common types of flu currently around. As this changes each year, it means you need a new jab each year too.

Flu jab and coronavirus (Covid-19)

If you have coronavirus (Covid-19) you shouldn’t have the jab until you’re better. We don't know whether the flu jab will offer any protection against Covid-19. That's why it's important to continue to follow local guidance. But we do know that the flu jab is the best way of protecting yourself against flu.

Tips for getting the flu jab

You need to be aware of the following:

• If you have an illness or infection – including Covid-19 – and you feel like you have a fever, don’t get the flu jab. Wait until you’re better or speak to a healthcare professional about when to have it.
• If you’ve had a serious reaction to a flu jab in the past, tell the nurse and they will give you a different jab – don’t just go without it.
• The jab is made using eggs, but if you’re allergic to eggs, you can get an ‘egg-free’ jab. Your healthcare professional can help you find out more about this.

Where and when to book your flu jab (UK)

Book your flu jab appointment for early autumn if possible (September onwards). Contact your GP to book your jab if they haven't already got in touch. Or if it’s quicker and easier, get one from your local pharmacy, like Tesco or Boots.

If you can't leave your home

If you are housebound, speak to your GP as community workers may be able to come out and give you the jab at home.

If you're a parent

If your child is 8 or under or you’re caring for someone with learning difficulties, they may be offered a nasal spray by their GP or healthcare team instead of a flu jab to protect them against the flu. Children over 8 will be offered the flu jab.

Possible side effects

After any vaccination you may have side effects. This is natural and they’ll usually go after a few days. Using over-the-counter medications, like paracetamol, and drinking plenty of sugar-free drinks will help if you get a high temperature.

You might find your blood sugar levels are higher than normal. This will usually settle. But if your blood sugar levels remain consistently high, or you experience anything other than these mild side effects, you must tell your doctor or healthcare professional.

If you get flu

If you don’t get the jab in time, you might get flu. Your doctor or nurse should tell you what to do if you’re unwell, and we have lots of information about it too. You might hear these called your sick day rules.
If you take an SGLT2 inhibitor tablet, you should stop this when you’re not well. Your blood sugars may rise when you’re not well so don’t stop taking any other diabetes treatment. And see your doctor or nurse soon, before it gets serious.

Keep warm

You really need to keep warm during the winter, both indoors and outdoors. If your house is too cold, turn up the heating to at least 18°C (65°F).

Keep testing your blood sugars

Being unwell can cause your blood sugars to go up and down. If you normally test your blood sugar, you may need to do it more often depending on your diabetes treatment.

Keep hydrated and eat

Living with diabetes and being unwell can be made worse if you don’t keep your fluids up. Some medications mean you need to eat regularly, so try to eat a little and often. Carbohydrate-based drinks, like milk or juices, may help you manage your blood sugars alongside any medication.

Go to your GP

If your symptoms don’t improve, you need to see your GP. Don’t waste time. Leaving things until they get worse might lead to more serious infections.

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/flu-jab?utm_source=bronto&utm_medium=email&utm_term=Find+out+more&utm_content=Find+out+more&utm_campaign=Enewsletter+September+2020#where

Facts About Diabetes And Flu

From nfid.org

November is National Diabetes Month, and the National Foundation for Infectious Diseases (NFID) is highlighting the importance of annual influenza (flu) vaccination as a critical component of diabetes management. Healthcare professionals who treat patients with diabetes know how important it is to advise them to take certain steps to stay healthy, including:

• Eat a balanced diet,
• Exercise,
• Monitor and control blood sugar, and
• Take medication as prescribed

But there is one thing you may not know…annual flu vaccination is just as important to protect their health. The American Diabetes Association recommends that people with diabetes get vaccinated against flu every year.
According to the Centres for Disease Control and Prevention (CDC), diabetes—even if well managed—can make it harder for the immune system to fight respiratory infections such as flu or pneumonia, putting patients at greater risk for serious complications. Studies show that people with diabetes are three times more likely to die and six times more likely to be hospitalized due to flu-related complications, compared to people without diabetes.

Flu Complications for People with Diabetes

For people with diabetes, serious flu-related complications may include:

• Worsening of diabetes (poor glycaemic control and acidosis),
• Permanent physical decline and loss of independence
• Hospitalization or even death

Despite these risks, a recent NFID survey found that one out of four US adults who are at greater risk for flu-related complications (including people with diabetes and other chronic health conditions) do not plan to get vaccinated this flu season. The survey also found that 46 percent of high-risk individuals were unfamiliar with pneumococcal disease, and nearly 60 percent report that they have never been advised to get vaccinated against pneumococcal disease.

NFID recommends that healthcare professionals inform people with diabetes about the dangers of flu and pneumococcal disease and insist that they get vaccinated:

• Send reminders during the fall to ensure that patients schedule an office visit to discuss the importance of vaccination to prevent flu and pneumococcal disease
• If the practice does not provide vaccines, write a “prescription” for flu vaccine to emphasize the urgency and importance of flu prevention
• Discuss pneumococcal vaccination during the same visit, to avoid any missed opportunities

3 Tools to Help #LowerYourFluRisk

NFID has developed resources to help share the importance of annual flu vaccination and lower the risks of flu for patients with diabetes. Toolkit materials include:

• 30-second public service announcement (PSA) and short social media videos
• Infographics for healthcare professionals and patients about the importance of flu prevention for those with certain  chronic health conditions like heart disease, lung disease, and diabetes
• Sample social media posts and graphics

View the flu & chronic health conditions toolkit at: www.nfid.org/loweryourflurisk.

https://www.nfid.org/2019/11/07/facts-about-diabetes-and-flu/