People with diabetes (type 1, type 2, or gestational), even when well-managed, are at high risk of serious flu complications, which can result in hospitalization and sometimes even death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. In recent seasons, about 30 percent of adult flu hospitalizations reported to CDC have had diabetes. Flu also can make chronic health problems, like diabetes, worse. This is because diabetes can make the immune system less able to fight infections. Acute illnesses can make it harder to control your blood sugar. Flu may raise your sugar levels, but sometimes people don’t feel like eating when they are sick and a reduced appetite can cause blood sugar levels to fall. It is important for people with diabetes to follow the sick day guidelines if they become ill.

A Flu Vaccine is the Best Protection Against Flu

Flu vaccination is especially important for people with diabetes because they are at high risk of developing serious flu complications. Flu vaccines are updated each season as needed to keep up with changing viruses. Also, immunity wanes over time; annual vaccination is recommended for the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. (See Vaccine Virus Selection for this season’s exact vaccine composition.) Flu vaccines for 2020-2021 have been updated from last season’s vaccines to better match circulating viruses. Immunity from vaccination sets in after about two weeks.

• Flu vaccination has been shown to reduce the risk of getting sick with flu as well as reduce the risk of having a serious flu outcome like a stay in the hospital or even being admitted to the intensive care unit (ICU).
• Flu vaccination also has been associated with reduced hospitalizations among people with diabetes (79%)external icon. See “What are the benefits of flu vaccination?” for more information.

CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year by the end of October.

Flu Vaccines for People with Diabetes

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• Injectable influenza vaccines (flu shots) are recommended for use in people with diabetes and other health conditions. The flu shot has a long, established safety record in people with diabetes.
• The live attenuated influenza vaccine (LAIV), also known as the nasal spray vaccine, is recommended as an option for use in people 2 through 49 years old who are not pregnant. But, people with some chronic medical conditions (such as diabetes) should generally not received LAIV.  Your doctor or other health care professional can answer any questions you might have about flu vaccine.

Get pneumococcal vaccines.

• Having flu increases your risk of getting pneumococcal disease. Pneumonia is an example of a serious that can cause death.
• People who have diabetes also should be up to date with pneumococcal vaccination to help protect against pneumococcal disease. Pneumococcal vaccination should be part of a diabetes management plan. Talk to your health care provider to find out which pneumococcal vaccines are recommended for you.

Other Preventive Actions for People with Diabetes

In addition to getting a flu vaccine, people with diabetes should take the same everyday preventive actions CDC recommends of everyone, including avoiding people who are sick, covering coughs, and washing hands often.

Specific Health Actions for People with Diabetes

• Plan ahead to maintain sufficient supplies of your regular medications for chronic medical conditions (e.g. at least a 2-week supply)

Symptoms and Treatment

If you get flu symptoms call your health care provider right away. There are antiviral drugs that can treat flu illness and that may prevent serious flu complications. CDC recommends prompt flu treatment for people who have flu infection or suspected flu infection and who are at high risk of serious flu complications, such as people with diabetes.

Symptoms

Flu symptoms can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea, though this is more common in children People may be infected with flu and have respiratory symptoms without a fever.

Treatment

• Treatment should begin as soon as possible because antiviral drug treatment works best when started early (within 48 hours after symptoms start).
• Antiviral drugs require a prescription from a health care provider. These medicines fight against flu by keeping flu viruses from making more viruses in your body.
• Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
• There are four FDA-approved flu antiviral drugs recommended by CDC this season that can be used to treat flu.

When to Seek Emergency Medical Care

Anyone experiencing any of the following emergency warning signs of flu sickness, including people with diabetes, should seek medical attention right away.

Additional Resources for People with Diabetes