Understanding the Impact of Flu on Blood Glucose Control

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Understanding the Impact of Flu on Blood Glucose Control

The flu, also known as influenza, is a contagious respiratory illness that poses unique and significant challenges for individuals living with diabetes. Acute illnesses like the flu can make controlling blood sugar levels harder, and the flu may raise blood sugar levels. Understanding the complex relationship between influenza and blood glucose control is essential for managing health during flu season and preventing potentially life-threatening complications.

About 30% of adults hospitalized with flu reported to the CDC had diabetes in recent seasons. This statistic underscores the serious nature of influenza for the diabetes community. Upon infection with influenza virus, patients with diabetes have triple the risk of hospitalization, quadruple the risk of admission to the intensive care unit and double the risk of a fatal outcome compared to individuals with no underlying illness. These sobering numbers highlight why people with diabetes must take proactive steps to protect themselves during flu season.

How the Flu Affects Blood Glucose Levels

When you contract the flu, your body launches a complex immune response that has profound effects on blood glucose regulation. The mechanisms behind these changes involve multiple physiological systems working simultaneously, creating a perfect storm for blood sugar dysregulation.

The Stress Hormone Response

The flu may cause your body to release the stress hormones adrenalin or cortisol, which reduce the effectiveness of insulin, the hormone responsible for lowering glucose levels. This hormonal cascade is part of your body’s natural defense mechanism, but it creates significant challenges for glucose management.

Cortisol is released by the adrenal glands in response to stress and helps mobilize energy by increasing blood glucose levels. Cortisol does this by stimulating the liver to release stored glucose into the bloodstream and by promoting gluconeogenesis, the process by which the liver creates glucose from non-carbohydrate sources such as proteins. This means that even if you’re not eating, your blood sugar can continue to rise during illness.

The primary mechanism by which adrenaline raises blood sugar is by stimulating the liver to release more glucose, much like cortisol. Additionally, adrenaline inhibits the action of insulin, making it more difficult for cells to absorb glucose. This dual action creates a situation where glucose is being produced and released into the bloodstream while simultaneously becoming harder for your cells to use.

Insulin levels fall, glucagon and epinephrine (adrenaline) levels rise and more glucose is released from the liver. At the same time, growth hormone and cortisol levels rise, which causes body tissues (muscle and fat) to be less sensitive to insulin. This creates a state of insulin resistance that can persist throughout the illness and even for several hours afterward.

The Complexity of Blood Sugar Changes During Illness

While the flu typically causes blood sugar to rise, the situation is more nuanced than a simple increase. A reduced appetite when sick can cause blood sugar levels to fall. This creates a challenging situation where blood glucose can swing dramatically in either direction, making management particularly difficult.

Being ill can raise your blood sugar levels but the effects of the flu can also lower your appetite, potentially leading to dangerously low blood sugar levels if you aren’t able to eat. This bidirectional risk means that people with diabetes must monitor their blood glucose more frequently during illness and be prepared to respond to both high and low readings.

The feelings of illness can mask symptoms of high or low blood sugar. For this reason, you could develop hypoglycaemia or hyperglycemia without realising, both of which can be serious if not treated quickly enough. The overlap between flu symptoms and blood sugar symptoms makes it especially important to rely on glucose monitoring rather than how you feel.

The Role of Glycemic Variability

Recent research has revealed that it’s not just high blood sugar that’s problematic during flu infections—the fluctuations in glucose levels may be equally or even more damaging. In the context of the macro- and microvascular complications of diabetes (e.g., heart and kidney disease), there is now a growing body of evidence that glucose variability may have an even greater effect than hyperglycemia per se on physiological dysfunction.

Glycemic variability increases the severity of both a primary infection and a secondary infection with IAV. This increased disease severity was associated with increased pulmonary inflammation and markers of oxidative stress. This finding suggests that maintaining stable blood glucose levels during illness may be just as important as preventing high blood sugar.

Risks and Complications for People with Diabetes

The flu presents multiple serious risks for individuals with diabetes, extending far beyond temporary discomfort. Understanding these risks can motivate preventive action and help you recognize when medical intervention is necessary.

Increased Risk of Hyperglycemia

High blood sugar is one of the most common complications when people with diabetes contract the flu. When influenza infects a diabetic, blood glucose levels rise in response. This elevation can be substantial and difficult to control with standard diabetes management strategies.

If they have a fever, that actually increases the likelihood of becoming dehydrated, which limits the ability of the body to control blood glucose by flushing it in the urine. If your blood sugars are over 250 mg/dl, your body will be more resistant to your own insulin or the insulin you’re taking by injection, so that is also a concern. This creates a vicious cycle where high blood sugar leads to dehydration, which in turn makes blood sugar even harder to control.

Diabetic Ketoacidosis (DKA)

One of the most serious acute complications that can occur when people with diabetes have the flu is diabetic ketoacidosis. With insulin levels low, your body can’t effectively use the glucose circulating through it. Instead, it turns to using ketones for energy. The combination of ketones and high glucose levels can make your body too acidic to function properly. This is called diabetic ketoacidosis, and it’s an emergency that requires immediate medical attention.

If you take insulin, charity Diabetes UK recommend checking for ketones if blood glucose levels rise above 15 mmol/L. If your ketones become too high it is possible to fall into a diabetic coma and this can be fatal if untreated. This underscores the critical importance of ketone monitoring during illness for people who take insulin.

Hyperosmolar Hyperglycemic State (HHS)

The flu may also trigger another condition, called hyperosmolar hyperglycemic nonketotic syndrome (HHNS), in which your glucose levels are so high, your body essentially becomes dehydrated trying to compensate. It’s also a life-threatening emergency. This condition is more common in people with type 2 diabetes and can develop over days or weeks during illness.

Respiratory and Other Complications

Flu-related complications include pneumonia, bronchitis, sinus infections, and ear infections. People with diabetes are at higher risk for all of these complications compared to those without diabetes.

Diabetics — Type 1 and Type 2 — are at increased risk of serious flu complications and even death. Flu in diabetics is more likely to cause bronchitis, sinus and ear infections, and pneumonia. The combination of a weakened immune system and the metabolic stress of illness creates an environment where secondary infections can develop more easily.

A dangerous complication of the flu is pneumonia and people with diabetes are more at risk of developing this complication than people without diabetes. Pneumonia can be life-threatening, particularly for older adults with diabetes or those with other chronic health conditions.

Impact on the Pulmonary System

Research has revealed specific mechanisms by which diabetes increases flu severity at the cellular level. High glucose conditions prior to IAV infection increased virus-induced barrier damage. This was associated with an increased pro-inflammatory response in endothelial cells and the subsequent damage of the epithelial junctional complex.

Hyperglycaemia may increase influenza severity by damaging the pulmonary epithelial-endothelial barrier and increasing pulmonary oedema. This means that high blood sugar doesn’t just make you feel worse—it actually changes how the virus affects your lungs at a fundamental level.

Weakened Immune System

If you have diabetes, you also have a weakened immune system, which means your body is less able to fight off infections. Due to this weakened immune system, diabetics are more prone to infections than those without diabetes — and the course of infection is also more complex because the virus makes it tough to regulate blood sugar.

Persistently increased blood sugars can affect the immune system and increase the frequency of flu infections. This creates a bidirectional relationship where poor glucose control increases infection risk, and infections make glucose control more difficult.

Managing Blood Glucose During the Flu

Effective management of blood glucose during flu illness requires a proactive, comprehensive approach. The strategies you use when you’re healthy may need significant modification when you’re sick.

Increased Monitoring Frequency

If (in most cases, when) you get flu, it is important to check blood glucose levels more regularly than usual. Whilst you have flu, check as often as possible, because the feelings of illness can mask symptoms of high or low blood sugar.

Test your blood glucose levels at least every four hours and keep track of those numbers. Some healthcare providers recommend even more frequent testing, particularly if you’re experiencing significant symptoms or having difficulty maintaining stable glucose levels.

Frequency of blood glucose testing depends on your particular circumstances and the medication you take. If you are on hypo causing medication, it is advisable to test every few hours to monitor whether your sugar levels are going too high or low. This individualized approach ensures that you’re monitoring at the right frequency for your specific situation.

Ketone Monitoring

For people who take insulin, ketone monitoring becomes critically important during illness. If you have Type 1 diabetes, be sure to check your urine for ketones if your blood sugar is elevated to avoid diabetic ketoacidosis (DKA). If you do have high ketones, call your doctor immediately.

Moderate to large ketones in the urine are a warning sign that requires immediate medical attention. Don’t wait to see if ketones resolve on their own—contact your healthcare provider right away if you detect elevated ketones.

Medication Management

Even if you do not have an appetite and don’t eat, be sure to still take your pills or insulin. Your doctor may advise you to increase your insulin dosage during times of sickness, as your body makes extra glucose when you’re sick. Never stop taking your diabetes medications without consulting your healthcare provider, even if you’re not eating normally.

When you’re sick and not able to eat normally, you might need to adjust your insulin doses to keep your blood sugar under control. This is why having a sick day plan developed in advance with your healthcare team is so important—you’ll know exactly how to adjust your medications when illness strikes.

Nutrition and Hydration

Maintaining adequate nutrition and hydration during flu illness can be challenging but is essential for blood glucose management. Many people with diabetes don’t feel hungry or thirsty if they have flu. However, it is important to continue eating a healthy diet and drinking regular fluid to help manage your blood sugar and diabetes.

Try to continue your normal meal plan as much as possible. If your stomach is upset, try eating foods that are easy on the stomach, like crackers, applesauce or light soups. If you can’t keep solid foods down and your blood sugar drops, try liquids like juice or a sports drink. The goal is to maintain some carbohydrate intake to prevent dangerous drops in blood sugar while avoiding foods that might upset your stomach further.

It should also include strategies to increase fluids to prevent dehydration and flush out excess glucose and ketones if needed. Adequate hydration helps your kidneys eliminate excess glucose and prevents the dangerous dehydration that can occur with high blood sugar.

Over-the-Counter Medications

Many cold and flu medications sold over-the-counter contain sugar, so check the labels or ask your pharmacist for sugar-free options. This hidden sugar can significantly impact your blood glucose levels, especially when you’re already struggling to maintain control during illness.

Talk to your doctor about which over-the-counter and prescription medicines are best to take if you have diabetes. Some medicines have higher levels of sugar than others. Your pharmacist can be an excellent resource for identifying diabetes-friendly cold and flu remedies.

Rest and Stress Management

Rest as much as possible to help your body recover quickly and lower the amount of stress on your body. Adequate rest supports your immune system and can help reduce the stress hormone response that drives blood sugar higher.

Remember that illness itself is a form of physical stress, and your body needs additional resources to fight the infection. Pushing yourself to maintain normal activities can prolong illness and make blood glucose management more difficult.

Developing a Sick Day Plan

You should have a “sick day plan” made with your health care team. The sick day plan specifies when and how to adjust medication, diet, and glucose monitoring when you are not feeling well. This plan should be developed when you’re healthy, not when you’re already sick and struggling to think clearly.

Your sick-day plan may include recommendations on which medications to continue and at what dose and how many carbohydrates to consume throughout the day, in order to keep healthy glucose levels. Having these details worked out in advance removes the guesswork and stress of making decisions when you’re ill.

Talk with the doctor ahead of time about what medications are OK to take when you’re sick with the flu or a cold, and how to adjust your medications, if necessary. Also, talk with the doctor regarding when you should be calling them if blood sugars are high. Your sick day plan should include specific blood glucose thresholds that trigger a call to your healthcare provider.

Prevention: The First Line of Defense

While managing blood glucose during flu illness is important, preventing the flu in the first place is far preferable. Prevention strategies should be a cornerstone of diabetes management during flu season.

Annual Flu Vaccination

It is important for people with diabetes to get annual flu vaccinations to prevent flu and serious flu complications. The flu vaccine is the single most effective preventive measure available.

Flu vaccination is especially important for people with diabetes because they are at higher risk of developing serious flu complications. Flu vaccination also has been associated with reduced hospitalizations among people with diabetes (79%). This dramatic reduction in hospitalization risk demonstrates the real-world effectiveness of flu vaccination for people with diabetes.

People with diabetes should avoid the nasal spray flu vaccine, opting for injectable vaccines. Injectable influenza vaccines (flu shots) are recommended for use in people with diabetes and certain other health conditions. People with diabetes should generally not receive the nasal spray flu vaccine (i.e., the live attenuated influenza vaccine or LAIV). The injectable vaccine is preferred because it contains inactivated virus rather than live attenuated virus.

The flu vaccine is 40-60 percent effective and takes two weeks after the shot for your immunity to build up. The vaccine protects against four types of influenza strains that public health officials predict are most likely to strike in a given flu season. While the vaccine isn’t 100% effective, it significantly reduces your risk of infection and, if you do get the flu, typically results in milder illness.

Cases of flu usually peak in January or February, but you can still get infected any time up until May. Although it is recommended you get the vaccine as soon as it is available in the fall, even January is not too late. Don’t skip vaccination just because you think you’ve missed the optimal window—protection at any point during flu season is better than no protection.

Pneumococcal Vaccination

Having flu increases your risk of getting pneumococcal disease. Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. People with diabetes should be up to date with pneumococcal vaccination. This additional vaccine provides protection against bacterial pneumonia, which can develop as a secondary infection after the flu.

You can get the pneumococcal vaccine your provider recommends when you get a flu vaccine. Pneumococcal vaccination should be part of a diabetes management plan. Combining these vaccinations during the same visit makes it easier to stay up to date with recommended immunizations.

Everyday Preventive Actions

In addition to getting a flu vaccine, people with diabetes should follow the CDC’s everyday preventive actions. These include washing your hands frequently with soap and water, avoiding touching your face, staying away from people who are sick, and cleaning frequently touched surfaces regularly.

During peak flu season, consider additional precautions such as avoiding crowded indoor spaces when possible, maintaining good ventilation in your home and workplace, and being extra vigilant about hand hygiene. These simple measures can significantly reduce your exposure to influenza viruses.

When to Seek Medical Attention

Knowing when to contact your healthcare provider or seek emergency care is crucial for preventing serious complications. Don’t hesitate to reach out for medical guidance—early intervention can prevent minor problems from becoming major emergencies.

Contact Your Healthcare Provider If You Experience:

If you have diabetes and experience flu symptoms, call your health care provider right away. CDC recommends prompt flu antiviral treatment for people with diabetes who have flu infection or suspected flu infection. Antiviral medications are most effective when started within the first 48 hours of symptom onset.

The sooner the flu is diagnosed, the sooner doctors can give antiviral medications. These medications work best if taken in the first 48 hours of having the flu, and they can make you feel better faster. Additionally, they can reduce the chances of flu-related complications, which is especially important for people with diabetes.

Seek care if you have: Vomiting or diarrhea for more than six hours. Fever or sickness for longer than two days without improvement. Glucose levels higher than 240 mg/dL despite administering sick-day insulin. Moderate to large ketones in the urine. These are clear indicators that your illness is affecting your diabetes management in ways that require professional intervention.

Seek Emergency Care Immediately If You Experience:

Symptoms of ketoacidosis, such as fruity breath, difficulty breathing, dry mouth and skin, frequent urination and confusion. These symptoms indicate a medical emergency that requires immediate hospital treatment.

Other emergency warning signs include persistent chest pain or pressure, severe or persistent vomiting that prevents you from keeping down liquids or medications, confusion or inability to wake up, severe weakness or dizziness, or seizures. These symptoms require immediate emergency medical attention—call 911 or go to the nearest emergency room.

If you’re unsure whether your symptoms warrant medical attention, err on the side of caution and contact your healthcare provider. They can help you assess the situation and determine the appropriate level of care needed.

Special Considerations for Different Types of Diabetes

While the flu poses risks for all people with diabetes, there are some differences in how it affects people with type 1 versus type 2 diabetes, as well as special considerations for gestational diabetes.

Type 1 Diabetes

This effect is particularly concerning for individuals with type 1 diabetes, who rely on external insulin to regulate their blood sugar. Under stress, the body’s response can inadvertently lead to elevated blood sugar levels, even if the individual is following their prescribed insulin regimen.

People with type 1 diabetes are at particularly high risk for diabetic ketoacidosis during flu illness because they have no endogenous insulin production. This means that any interruption in insulin delivery or increased insulin resistance can quickly lead to dangerous ketone accumulation. Frequent blood glucose and ketone monitoring is absolutely essential for people with type 1 diabetes when they have the flu.

Type 2 Diabetes

People with type 2 diabetes face their own unique challenges during flu illness. While they typically have some endogenous insulin production, the insulin resistance that characterizes type 2 diabetes can be significantly worsened by illness. This can lead to extremely high blood glucose levels that are difficult to control with oral medications alone.

Some people with type 2 diabetes who don’t normally take insulin may need temporary insulin therapy during severe illness. This is not a sign of failure or disease progression—it’s a temporary measure to help manage blood glucose during the acute stress of illness.

Gestational Diabetes

People with diabetes (type 1, type 2, or gestational), even when well-managed, are at higher risk of developing serious flu complications that can result in hospitalization and sometimes even death. Pregnant women with gestational diabetes face additional concerns because the flu can affect both maternal and fetal health.

Pregnant women should be especially vigilant about flu prevention and should contact their healthcare provider at the first sign of flu symptoms. The risks of untreated flu during pregnancy far outweigh any concerns about antiviral medications, which are considered safe during pregnancy.

The Broader Impact: Flu Season and Diabetes Management

The relationship between flu and diabetes extends beyond the immediate illness period. Understanding the broader context can help you prepare more effectively and maintain better overall health.

Long-Term Effects on Glucose Control

Even after flu symptoms resolve, blood glucose control may remain disrupted for several days or even weeks. These hormonal responses to the low blood glucose may last for 6-8 hours – during that time the blood glucose may be difficult to control. This prolonged effect means you may need to continue more frequent monitoring and medication adjustments even after you start feeling better.

Some people experience a temporary worsening of their overall diabetes control following flu illness, with higher average blood glucose levels persisting for weeks. This underscores the importance of prevention—avoiding the flu entirely is far better than dealing with its lingering effects on glucose control.

Impact on Diabetes Complications

People with diabetes frequently have other chronic diseases, such as COPD (chronic obstructive pulmonary disease), hypertension and renal disease, that put them at high risk for influenza-related complications or hospitalization. The flu can worsen these existing conditions, creating a cascade of health problems.

For people with existing diabetes complications such as cardiovascular disease, kidney disease, or neuropathy, the flu can accelerate disease progression or trigger acute exacerbations. This makes prevention and early treatment even more critical for people with advanced diabetes or multiple comorbidities.

Psychological and Emotional Impact

The stress of managing diabetes during flu illness can take a significant psychological toll. The constant monitoring, medication adjustments, and worry about complications can be exhausting. It’s important to recognize this emotional burden and seek support when needed.

Many people with diabetes report feeling anxious or overwhelmed during illness, particularly if they’ve experienced serious complications in the past. Having a solid sick day plan and knowing when to seek help can reduce this anxiety and help you feel more in control.

Emerging Research and Future Directions

Scientific understanding of the relationship between diabetes and influenza continues to evolve, with new research revealing important insights that may shape future prevention and treatment strategies.

The Role of Inflammation

The increased production of proinflammatory mediators under the variable condition was observed both in vivo and in vitro, and this was associated with more severe influenza. This suggests that the inflammatory response triggered by both diabetes and influenza may interact in ways that worsen outcomes.

Understanding these inflammatory mechanisms may lead to new therapeutic approaches that target inflammation specifically in people with diabetes who have the flu. This could potentially reduce the severity of illness and improve outcomes.

Potential Therapeutic Approaches

It raises the intriguing possibility that the long-term administration of oxidative stress inhibitors (i.e., prior to influenza virus infection) could be a viable therapeutic approach to reduce the burden of influenza in persons living with diabetes with glycemic variability. This is consistent with the findings of previous studies showing that long-term treatment with N-acetylcysteine (an antioxidant) reduced the severity of influenza-like symptoms in people with nonrespiratory chronic degenerative diseases (including metabolic conditions).

While these approaches are still being researched and are not yet standard recommendations, they highlight the ongoing efforts to find better ways to protect people with diabetes from flu complications.

Importance of Continued Research

Given that global rates of diabetes mellitus are increasing, understanding how diabetes contributes to increased influenza severity has an important role in pandemic preparedness. As the prevalence of diabetes continues to rise worldwide, the intersection of diabetes and infectious diseases becomes increasingly important for public health.

Continued research in this area will help develop better prevention strategies, more effective treatments, and improved guidelines for managing diabetes during flu illness. Staying informed about new research findings and recommendations from organizations like the CDC and American Diabetes Association can help you benefit from the latest advances in care.

Practical Tips for Flu Season Preparation

Being prepared for flu season can make a significant difference in how well you manage if illness strikes. Here are practical steps you can take to be ready.

Stock Your Sick Day Supplies

Before flu season begins, assemble a sick day kit that includes:

  • Extra blood glucose test strips and lancets
  • Ketone testing supplies (if you take insulin)
  • A working thermometer
  • Sugar-free cough drops and cold medications approved by your healthcare provider
  • Easy-to-digest foods like crackers, applesauce, and broth
  • Electrolyte replacement drinks without added sugar
  • A written copy of your sick day plan
  • Contact information for your healthcare providers

Having these supplies on hand means you won’t need to make a trip to the pharmacy when you’re feeling terrible, and you’ll be able to start managing your illness immediately.

Review Your Sick Day Plan Annually

Your sick day plan should be reviewed and updated at least annually, or whenever there are changes to your diabetes medications or overall health status. Make sure you understand all aspects of the plan and don’t hesitate to ask your healthcare provider questions about anything that’s unclear.

Keep copies of your sick day plan in multiple locations—with your diabetes supplies, on your phone, and shared with family members who might need to help you if you’re too ill to manage on your own.

Communicate with Your Support Network

Make sure family members, roommates, or close friends know about your diabetes and understand the basics of your sick day plan. They should know warning signs that require emergency care and have contact information for your healthcare providers.

Consider designating a specific person who will check on you daily if you become ill, especially if you live alone. This person can help ensure you’re monitoring your blood glucose appropriately and can recognize if you need medical attention.

Maintain Good Overall Diabetes Control

The better your diabetes control is before you get sick, the easier it will be to manage during illness. Work with your healthcare team to optimize your blood glucose control throughout the year, not just during flu season.

Regular exercise, healthy eating, stress management, and consistent medication adherence all contribute to better baseline glucose control. This foundation makes it easier to weather the metabolic storm of flu illness.

Resources and Support

You don’t have to navigate the challenges of diabetes and flu season alone. Numerous resources are available to provide information, support, and guidance.

Healthcare Team

Your primary healthcare team—including your primary care physician, endocrinologist, diabetes educator, and pharmacist—should be your first resource for personalized guidance. Don’t hesitate to reach out with questions or concerns, especially if you’re developing a sick day plan or experiencing illness.

Online Resources

Reputable organizations provide valuable information about diabetes and flu:

These organizations regularly update their guidance based on the latest research and recommendations, making them reliable sources for current information.

Support Groups and Communities

Connecting with others who have diabetes can provide emotional support and practical tips for managing illness. Many communities have local diabetes support groups, and numerous online communities offer forums for sharing experiences and advice.

Hearing how others have successfully managed diabetes during flu illness can provide reassurance and practical strategies you might not have considered. However, remember that online advice should never replace guidance from your healthcare providers.

Conclusion

The flu poses significant challenges for people with diabetes, affecting blood glucose control through multiple mechanisms and increasing the risk of serious complications. People with diabetes are two times more likely to die from influenza than people with no underlying medical condition. This sobering statistic underscores why understanding and preparing for flu season is not optional for people with diabetes—it’s essential.

The complex interplay between influenza infection and diabetes involves stress hormone release, insulin resistance, immune system dysfunction, and direct effects on lung tissue. These mechanisms can lead to dangerous complications including hyperglycemia, diabetic ketoacidosis, hyperosmolar hyperglycemic state, and severe respiratory infections.

However, with proper preparation and management, you can significantly reduce your risk of flu-related complications. Annual flu vaccination remains the cornerstone of prevention, with demonstrated effectiveness in reducing hospitalizations among people with diabetes. Developing a comprehensive sick day plan with your healthcare team, maintaining supplies for illness management, and knowing when to seek medical attention are all critical components of staying safe during flu season.

If you do contract the flu, increased monitoring frequency, careful attention to hydration and nutrition, appropriate medication adjustments, and early medical intervention can help prevent minor problems from becoming major complications. Remember that seeking medical attention early is always preferable to waiting until a situation becomes critical.

As research continues to reveal new insights into the relationship between diabetes and influenza, management strategies will continue to evolve. Staying informed about current recommendations and maintaining open communication with your healthcare team will help ensure you benefit from the latest advances in care.

The flu can disrupt blood glucose control and pose serious health risks for people with diabetes, but with vigilance, preparation, and appropriate medical care, you can navigate flu season safely. Take the time now to get vaccinated, develop your sick day plan, and prepare your supplies. These proactive steps can make all the difference in protecting your health during the challenging months of flu season.