Do You Really Need a Flu Shot? Here’s What Diabetes Changes

If you live with a form of diabetes, there’s almost no doubt that your healthcare provider (HCP) has urged you to get a flu shot. In the United States, influenza (flu) vaccines are recommended for everyone over six months old, but getting vaccinated is especially important if you have diabetes.

Why is the flu worse if you have diabetes?

Dr. Marina Basina, an endocrinologist at Stanford, explains that “If a person with diabetes gets the flu, it becomes much more difficult to manage blood sugars—any infection will elevate blood sugars and increase variability in the readings and resistance to insulin. On the other hand, fevers, sweats and poor appetite may lead to low blood sugars, or ketone formation even in the setting of normal blood sugars.”

Diabetic ketoacidosis (DKA) can be deadly if left untreated, and it is more frequent in the setting of flu even when blood sugars are not significantly elevated.

Flu shots are a safe, inexpensive and effective way to lower your risk of getting sick. One study found that flu vaccination is associated with a 79% lower rate of hospitalizations for flu-related complications among people with diabetes. Still, many people hesitate to get vaccinated. 

In this guide, we explain why it’s important for PWD to get flu shots, debunk common myths and misconceptions and share current guidance from the Centers for Disease Control (CDC) on vaccine recommendations for PWD.

Why it’s important for people with diabetes to get flu shots

Managing diabetes while sick with the flu is a huge nightmare. If you can’t eat or are vomiting, you’re at risk for low blood sugars (hypoglycemia) and may have difficulty treating them. At the same time, blood sugars can run high because the immune system is fighting an infection or because of dehydration associated with illness, putting you at a higher risk of developing ketones and needing medical assistance.

Additionally, people with type 1 diabetes (T1D) and type 2 diabetes (T2D) are at a higher risk of developing flu complications like pneumonia, bronchitis, sinus and ear infections that can lead to hospitalization. No one wants that!

Debunking common myths and misconceptions about the flu shot

Social media and the current geopolitical climate have made it hard to separate fact from opinion. While getting the flu shot is a personal choice, there are real reasons to get one if you have diabetes. And flu shots are usually extremely safe for most people.

Here are some common objections and questions we’ve heard within the diabetes community about getting flu shots, answered:

• “Why can’t I just get one flu shot—why do I have to get one every year?” There are many strains of the influenza virus, and they constantly change, so vaccines change every year to stay effective.
• “I got a flu shot, but I still got sick. Flu shots don’t work!” Again, this has to do with the many different influenza strains that change constantly. It may also depend on how soon you got sick after getting the shot, since it takes two weeks to reach full effectiveness. Seasonal flu shots can’t cover every flu variety. So yes, you can still get sick even if you get a flu shot, but you can cut your odds of getting sick during flu season by about 40-60%. Getting a flu shot may still reduce your risk of severe complications, like those listed above, even if you still get sick.
• “I feel sick after getting the flu shot.” Getting a flu shot cannot cause flu illness. Flu shots consist of inactivated flu virus or, in recombinant vaccines, no virus at all. Some people do experience mild side effects after getting a flu shot, including soreness where the shot was given, low-grade fever, headaches and achiness. These side effects are minor and brief, especially compared with how severe the flu can be for someone with diabetes. Most of these side effects are totally normal and are listed on the paper you have to sign before getting your shot.
• “Other people can just get them—I don’t have to.” While flu shots are an effective step an individual can take to protect themselves, vaccines are most effective when everyone gets them. By getting vaccinated against the flu, you protect not only yourself but everyone you come in contact with. Have a safe and healthy flu season!

Can I get the COVID-19 vaccine and flu shot at the same time?

The CDC recommends yearly COVID-19 vaccination based on individual risk. Diabetes—both T1D and T2D—is on their list of conditions that raise your risk for severe COVID-19, so it’s worth getting vaccinated each fall if you fall into that group. It’s also safe to get your flu shot at the same visit. 

Just know you might notice slightly more mild side effects when you get them together, like:

• Fatigue
• Headache
• Muscle aches

It’s usually nothing serious, and it typically clears up fast. Serious reactions to either vaccine are rare. The CDC reports about 1.35 cases of anaphylaxis (a severe allergic reaction) per million flu vaccine doses and about five cases per million COVID-19 vaccine doses, and both are treatable on the spot if they happen.

If you’d rather space them out, that works too. For more on vaccine safety, the CDC has extensive resources and documentation.

It’s your call, but here’s the bigger picture

Getting a flu shot is a personal decision, and only you know what’s right for your body. But it’s worth remembering that vaccination protects more than just you. When more people get vaccinated, fewer flu strains circulate, which means fewer chances for the virus to spread to someone whose body can’t fight it off as easily, like a newborn, an older relative or someone managing another chronic condition.

If you lived through the height of COVID-19, you know what it looks like when a virus outpaces our ability to manage it. For people with diabetes, a “short” illness rarely stays short. Blood sugar swings, dehydration, and the added strain on your body can turn a routine flu into a much bigger ordeal and take weeks to recover from. A yearly flu shot is one of the simplest tools you have to lower those odds, for yourself and for the people around you who are counting on all of us to do our part.

Where to get your flu shot

Getting a flu shot is quick and usually free with insurance. You can get one at your HCP’s office, local pharmacy or a community health clinic. Many places even take walk-ins.

The CDC recommends getting vaccinated by the end of October, before flu season ramps up into high gear. If you miss that window, it’s still worth getting your shot since the flu can circulate well into spring.

Before you go:

• Bring your insurance card. Most insurance plans, including Medicare Part B, cover the flu shot at no cost to you. If you don’t have insurance, ask your HCP or local health department about free or low-cost options.
• Mention that you have diabetes. The CDC advises caution with the nasal spray flu vaccine for people with diabetes, so the shot is recommended. Talk to your HCP or pharmacist and they can help you choose.
• If you’re 65 or older, ask about higher-dose flu vaccines designed for older adults.

After your shot: Check your blood sugar a little more often for a day or two. Mild side effects like achiness or a low-grade fever are normal and might affect your blood sugar. Drink plenty of water, and keep your sick-day supplies nearby to make those first few days a little easier.

Learn more about other ways you can optimize your diabetes management and protect yourself from the unknowns in our Beyond Diagnosis guides.