Chronic Health Conditions and the Flu: A Deadly Combination

For most people, the flu is a mild yet unpleasant illness. Fever, chills, congestion, sore throat, muscle aches and fatigue generally leave people feeling lousy for a few days. Most people who catch the flu do not need medical care and fully recover in less than two weeks. However, seniors and individuals with compromised health face very different risks.

Influenza (flu) is a contagious and potentially deadly virus that can result in serious complications for individuals living with chronic health conditions such as heart disease, lung disease, and diabetes, even when chronic conditions are well-controlled. Estimates indicate that 31 percent of US adults age 50-64 years and 47 percent of those age 65 and older have at least one chronic health condition that puts them at high risk for flu-related complications, including hospitalization, catastrophic disability, and even death.

Elderly people who have chronic health conditions are particularly at risk for several reasons. First, the immune system weakens with age, leaving older adults more vulnerable to disease. Secondly, chronic health conditions can exacerbate the flu, making it worse, which leads to serious complications. Likewise, the flu can make chronic health problems worse.

There is an urgent need to raise awareness of the burden of flu in adults with chronic health conditions. Healthcare professionals (HCPs) play a key role in communicating the known benefits of annual flu vaccination in mitigating the risks of flu and reducing severe flu-related outcomes in patients with chronic health conditions. Additionally, HCPs must be prepared to recognize and address barriers to vaccination, including lack of consumer confidence in vaccine efficacy and misperceptions about the impact of flu, and should insist upon annual flu vaccination—particularly for patients with known chronic health conditions and for those who may have an undiagnosed chronic health condition or are likely to spread flu to others.

What to Watch For

Anyone with diabetes should receive a flu shot annually. There is still time to get one to help prevent the illness this season. Should you come down with the flu, the CDC offers these guidelines for diabetics who are sick with flu-like symptoms:

• Take your diabetes pills or insulin, even if you can’t eat. Your doctor may advise you to take even more insulin, if necessary.
• Test your blood sugar every four hours, and track results.
• Drink extra water or calorie-free liquids, and try to eat your normal diet. If you can’t handle solid foods, try soft foods or liquids with a similar amount of carbohydrates.
• Weigh yourself every day. Persistent high blood glucose levels can cause weight loss.
• Check your temperature every morning and evening. A fever may mean infection.

Call your doctor or go to an emergency room if any of these occur to you:

• Too sick to eat normally and can’t keep food down for more than 6 hours.
• Severe diarrhea.
• Loss of five or more pounds.
• Temperature over 101 degrees F.
• Blood glucose lower than 60 mg/dL or remains over 250 mg/dL on two checks.
• Moderate or large amounts of ketones in urine. According to the Joslin Diabetes Center, ketones are produced by diabetics’ livers from fat when there’s not enough insulin to process glucose in the blood.
• Trouble breathing.
• Feel sleepy or can’t think clearly.

If a person with diabetes thinks they may have the flu, are running a high temperature, or having rapid blood sugar changes, they should call their doctor.