Diabetes and Influenza

COMING  down with a case of the flu is no fun for anyone.  But it poses extra risks for people with diabetes or other chronic health problems.

A bad case of the flu can lead to viral or bacterial pneumonia, dehydration, ear infections and sinus infections, especially in children.  Influenza can also make chronic medical conditions such as diabetes, asthma and congestive heart failure worse.  Though numbers vary from year to year, an annual average of more than 200,000 hospitalizations and approximately 36,000 deaths are attributed to influenza or complications from influenza in the United States alone.  On a global scale, the flu is responsible for the deaths of half a million people each year.  People with diabetes make up a disproportionately large number of those affected.  They are six times more likely to be hospitalized with flu complications than the population at large.  Deaths among people with diabetes rise 5 to 15 percent during flu epidemics, according to the Centers for Disease Control.  Each year, between 10,000 and 30,000 deaths among people with diabetes are associated with influenza and pneumonia. 

WHY INFLUENZA  IS ESPECIALLY DANGEROUS FOR PEOPLE WITH DIABETES.  Flu symptoms such as fatigue can make it harder to perceive both high and low blood-glucose episodes.   Some medicines, antibiotics and steroids used to treat illness can also raise blood-glucose levels.

” A lot of times people with think that because they aren’t eating, their blood sugar isn’t going to go up,” said Kris Bischoff, certified diabetes educator and registered dietitian at Adams Memorial Hospital in Decatur, Indiana.  “What people don’t understand is that when you are sick, your body has that fight-or-flight response.”  Because your body can’t run away from the germs that are causing the infections, it dumps sugar into your bloodstream to help prepare for battle.  “For some people,” she explains,”a higher blood sugar reading is the first sign that they are getting sick or getting an infection.”

Diabetes can compromise the body’s immune system, making it less effective at fighting viral infections such as the flu.  This puts people with diabetes at greater risk of developing secondary infections such as pneumonia.  And pneumonia is nothing to take lightly; according to the CDC, about 5 percent of cases involving adults who develop pneumonia result in death.

People with type 1 diabetes who get influenza may be more prone to dangerous levels of ketones.  This can cause diabetic ketoacidosis (DKA), which can result in coma or even death.

THE HIDDEN BENEFITS OF GETTING A FLU SHOT FOR PEOPLE WITH TYPE 2 DIABETES    The best way to protect yourself against influenza and the complications that can arise is to get a flu shot.  Not only does the vaccine protect against some of the viruses that can cause influenza, but a recent study has suggested that people with type 2 diabetes who receive flu vaccinations may have a reduced rusk of cardiovascular disease.

The study, published in July 2016 in The Canadian Medical Association Journal, sought to examine the effectiveness of influenza vaccination in preventing hospital admissions for cardiovasular and respiratory conditions.  The research subjects were 124,503 British adults with type 2 diabetes who were studied over a 7 year period, from 2003-2010.  About two-thirds of the people in the study had received influenza vaccinations.

Even after controlling for variables such as age, sex, smoking, medications and body mass index, the researchers found that having received a flu shot was associated with a 30% reduction in flu-season hospital admissions for stroke.  Hospital admissions for heart failure were down 22%, hospitalizations for heart attack were down 19%, and hospitalizations for pneumonia or influenza were down 15% among people with type 2 diabetes who had received a flu shot.

MOST SIGNIFICANT OF ALL:  The death rate among those who received a flu shot was 24% lower than in those who had not been vaccinated, the researchers said.

The study wasn’t intended to prove a cause-and-effect relationship between influenza vaccine and the reductions in death and hospital admissions.  However, the results do suggest that the benefits of getting a flu shot extend beyond simple peace of mind.

References:  DiabetesHealth Magazine/ DEC. 2016  pg. 8-10