Should You Get the Flu Shot if You Have Diabetes? What's All the Fuss About?

The flu is an infection of the nose, throat and lungs caused by the influenza viruses. If you have diabetes or another chronic health condition, chances are your healthcare provider or team asks you about getting the flu shot on a regular basis. Wondering what all the fuss is about? Read on to find out!


Diabetes and the flu shot | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian

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Should you get the flu shot if you have diabetes?


Yes, while the flu shot is recommended to anyone six months of age or older, it is especially recommended for people with diabetes. Diabetes Canada and the American Diabetes Association both recommend that people with diabetes should receive an annual influenza vaccination (flu shot) during flu season to reduce the risk of influenza-related hospitalizations and death.




Why is the flu shot recommended for people with diabetes?


While most people will recover from a flu in 7 to 10 days, severe illness resulting in complications and hospitalization can happen. Some groups, including people living with diabetes, are at a higher risk for developing complications or requiring hospitalization (and intensive care) due to catching the flu.


Diabetes increases your risk of flu-related complications and hospitalization | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian


Complications as a result of the flu include:

  • Pneumonia (infection of the lungs)

  • Myocarditis (inflammation of the heart)

  • Encephalitis (inflammation of the brain)

  • Rhabdomyolysis (inflammation of muscle tissues)

  • Multi-organ failure (e.g. respiratory and kidney failure)

  • Sepsis (a life-threatening inflammatory response to infection)


Complication of the flu include pneumonia, myocarditis, encephalitis, rhabdomyolysis, multi-organ failure, sepsis | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian


Other chronic health conditions that increase the risk of flu-related complications include:

  • Heart disease

  • Lung disease (includes bronchopulmonary dysplasia, cystic fibrosis, asthma)

  • Cancer and immune compromising conditions

  • Kidney (renal) disease

  • Anemia or hemoglobinopathy

  • Neurologic or neurodevelopmental conditions


The flu shot protects you from the most common strains of the flu each year. Therefore, getting vaccinated against influenza each fall is the most effective way to help prevent getting sick from the flu and its complications.




When should you get the flu shot?


In Canada, cases of the flu tend to rise over the fall and peak in the winter months. Flu shots start to be available early fall - before the onset of the flu season. But, vaccination later into the flu season is still effective! Just keep in mind, the flu shot takes about two weeks to take effect.


While flu shots don’t provide 100% protection against getting the flu, they help make it less likely for you to catch the flu for about six months.




How does the flu impact blood sugar?


Getting sick with the flu can make blood sugar more difficult to manage. When we get sick, our bodies increase the secretion of stress hormones (e.g. cortisol, adrenaline and glucagon). These hormones work against insulin to raise blood sugar.


On the flip side, if your blood sugar has been trending above target, it can also make the effects of the flu more dragged out as high blood sugar dampens your body’s immune response.


How does the flu impact blood sugar | Beyond Diabetes Nutrition - Lucy Zhang, Registered Dietitian



Can the flu shot cause blood sugar to be higher than usual?


Though not common, in some people, the flu shot can temporarily cause blood sugar levels to sit higher than normal. This is related to the release of stress hormones as your immune response reacts to the vaccine. This is temporary and should resolve.


Most likely, you’ll just be left with a sore arm for a day or two. Other common reactions include pain, soreness, redness or swelling at the injection size. You may also experience muscle aches and fatigue.




Do you need to space out the timing between my flu shot and COVID-19 vaccine?


No. Current guidance from the NACI (National Advisory Committee on Immunization) indicates the flu shot can be given at the same time as, or any time before or after other vaccines, including COVID-19 vaccines.




What else can we do to avoid catching the flu?


Don’t forget to continue to keep up other precautions (which I think we have all gotten much better at with COVID):

  • Cover your nose and mouth with a tissue when coughing or sneezing

  • Wash your hands often with soap and water. Alcohol-based hand sanitizers are also effective

  • Avoid touching your eyes, nose, or mouth

  • When possible, try to avoid close contact with others when they are sick



If you are wondering where to get your flu shot, check out this page for more info specific to your province!






References


Flu (influenza): For Health Professionals. Public Health Agency of Canada. https://www.canada.ca/en/public-health/services/diseases/flu-influenza/health-professionals.html#a5. Accessed Dec 21, 2021.


Flu Symptoms and Complications. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/symptoms/symptoms.htm. Accessed Dec 21, 2021.


Flu and Pneumonia Shots. American Diabetes Association. https://www.diabetes.org/healthy-living/medication-treatments/flu-and-pneumonia-shots. Accessed Dec 21, 2021


Glaess SS, Benitez RM, Cross BM, and Urteaga EM. Acute Hyperglycemia After Influenza Vaccination in a Patient with Type 2 Diabetes. Diabetes Spectr. 2018;31(2): 206-208.


Guidance on the Use of Influenza Vaccine in the Presence of COVID-19. National Advisory Committee on Immunisation (NACI). https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/guidance-use-influenza-vaccine-covid-19.html. Accessed Dec 21, 2021.


Husein N, Chetty A. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Influenza, Pneumococcal, Hepatitis B and Herpes Zoster Vaccinations. Can J Diabetes 2018;42:S142-S144.


National Advisory Committee on Immunization (NACI). Canadian Immunization Guide Chapter on influenza and statement on seasonal influenza vaccine for 2021-2022. Ottawa: Public Health Agency of Canada. 2021.



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