It’s Cold and Flu Season—Here is What to Do if You Have Diabetes
As the cold and flu season settles in, staying healthy becomes more challenging—especially for people with diabetes, who face added risks when illness strikes.
Viral infections can make it harder to manage blood sugar levels, raising the likelihood of complications. Being prepared and taking preventive measures is key to staying on track and avoiding setbacks during this time.
Here’s what you need to know to keep yourself well through the season.
Be sure to first talk to your doctor before starting a cold and flu management plan for your diabetes.
What’s the Difference Between a Cold and Flu?
- A cold is a milder respiratory infection compared to the flu.
- Both the cold and flu can cause symptoms like a sore throat, cough, runny nose, and congestion.
- The flu is typically accompanied by body aches and fever.
- The flu also tends to last much longer than a common cold.
As someone living with diabetes—or as a caretaker of a person with diabetes—you should plan ahead so you’re ready for the cold and flu.
Sick-Day Plan if You Have Diabetes
- Your doctor’s contact information and know when to call.
- Lists of over-the-counter medications you should take to alleviate certain symptoms.
- A plan of action (if/then scenarios), including how often you should check your blood sugar levels, how to adjust your insulin or oral medication (if you need to), and if and when to check for ketones.
Food + Drink Stock Up
- Diet, clear sodas, without caffeine
- Clear broths
- Sugar-free popsicles
- Glucose gel (fast-acting to treat lows)
- Sports drinks (for fast-acting sugars and electrolytes)
- Regular ginger ale
- Soft, bland foods (like oatmeal or saltine crackers)
Get Your Gear
- Glucagon kit
- Ketone test strips
- ‘(with extra batteries)
- Continuous glucose monitor (CGM) and/or pump supplies
- A week’s worth of glucose-lowering medication
- Thermometer
- Tylenol* (or Acetaminophen) for fever
- Cold/flu medication
Get a Flu Shot
Flu shots are usually offered in the fall and are highly recommended for anyone who is at higher risk for complications if they contract influenza.
Wash Your Hands
You’ve heard it a million times, but it really is one of the best ways to prevent contracting a virus or bacterial infection.
What to Do if You Do Get a Cold or Flu
Stay Hydrated
Drink 8 ounces of water or clear broth every hour. If you’re having trouble keeping liquids down, take small sips frequently throughout the day.
Stay Nourished
Try to eat something with carbs every hour. If your glucose is running low, use the 15-15 rule to treat.
Stay Vigilant About Your Blood Sugar Levels
- Frequently check your glucose levels.
- When you’re fighting off an infection, your blood sugar levels tend to run a little higher, thus necessitating more insulin than usual.
- However, if you’re severely dehydrated, are vomiting, or are simply unable to eat, your glucose may drop.
- Also, aspirin in large doses can lower blood sugar levels, while decongestants can raise them.
The bottom line—you should check glucose more frequently if you’re sick. If you use a CGM, keep a blood glucose meter handy as backup and to confirm the results when needed (if you feel physically different than what the CGM is telling you).
Make Sure You Aren’t in DKA
Check for ketones every four to six hours and more frequently if your glucose is above 240 mg/dL . The following are symptoms of DKA. Call your doctor immediately if you experience:
- High ketones
- Thirst or dry mouth
- Frequent urination
- Drowsiness
- Dry or flushed skin
- Nausea, vomiting, or abdominal pain
- Difficulty breathing
- Fruity odor on breath
- Confusion
Check Your Temperature
Check your temperature regularly. If you are running at 101°F or higher for at least 24 hours, you should contact a doctor.
Take Your Prescribed Medicine
When choosing between pills and syrup, choose pills because pills are less likely to have carbs. There are sugar-free options in syrups as well, so always check your label and dose insulin accordingly. While not food, you have to dose for meds (if they have carbs)!
You can treat the flu with antiviral prescription medications that can ease symptoms and shorten the duration of your illness, such as oseltamivir (Tamiflu). For best results, contact your doctor as soon as you notice symptoms, as treatment is most effective when started right away.
* Tylenol (or Acetaminophen) the fever/pain reducer, is known for interfering with some CGMs. Use a blood glucose meter to double check your results when your symptoms don’t match your CGM reading.
Be Prepared, Stay Vigilant, and Consult Your Healthcare Team
Taking these extra steps can make a big difference in managing your health through the cold and flu season.
By being prepared, staying vigilant, and consulting with your healthcare team, you can minimize disruptions to your diabetes management and reduce the risk of complications.
Remember, planning ahead is key to staying resilient and healthy—even when viruses are making the rounds. Stay proactive, stay informed, and take care of yourself this season!
Verified by Natalie H. Strand, MD and Melanie Batchelor, MHS, RD, LDN, CDCES
