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November 3, 2020

The flu season is here again. Knowing more about the flu virus, how it spreads and how to protect yourself is very important especially if you have a chronic disease like diabetes.

What causes flu?  Flu is a respiratory illness that is caused by influenza virus. Flu virus affects the lungs and breathing.

How does it spread?  The flu virus spread from person to person through droplets (small virus particles). When an infected person talks, sneeze or cough, these droplets are released and can get into the mouth or nose of another person or be breathed in by a person nearby. The droplets can also land on objects, if one touches contaminated objects or surfaces and then touches their eyes or nose, they can get the flu. If you are infected with the flu virus, you can spread the flu to others even before you know you are sick with the virus and when you are sick too.

What are the symptoms of flu? The symptoms of flu include fever, dry cough, chest discomfort, sore throat, muscle and body aches, headache, tiredness and runny nose. The cough and body pain can become severe. Some people may experience diarrhea and vomiting. Most people will recover from the fever and other symptoms within a week, but some people may have a very severe illness or can lead to death.

What is the fuss about the flu when I have diabetes?  Flu infection can have a serious effect on people living with diabetes. People with diabetes even when well managed are at higher risk of serious flu related complications, hospitalization and even death. These complications include bronchitis, worsening of chronic heart disease, pneumonia, sinus and ear infections. People with diabetes often have other chronic diseases such as COPD, hypertension and kidney disease that puts them at higher risk for flu related complication and hospitalization. Flu vaccination can reduce the rate of hospitalization and death from flu and flu related complications like pneumonia.

What is the treatment for flu? Flu can be treated with anti-viral drugs to make flu illness milder, shorten time of sickness and reduce severe complication and death. The antiviral drug work best when administered within 2 days of start of illness. It is available through prescription in forms of pill, liquid and inhaler. This antiviral drug for flu does not treat COVID-19.

For people living with diabetes, flu can cause blood glucose to fluctuate, it can become raised and if you are not eating due to flu infection, this can cause your blood glucose to go low. If you have the flu, drink plenty of fluid, get plenty of rest, check your blood glucose more frequently, you may need to check for ketones if you have type 1 diabetes, follow the sick day management plan that was developed by your diabetes care team. For more information about diabetes sick day management guidelines click here

When to contact your health care provider:

If you are experiencing worsening symptoms such fever or cough that improved and then return or worsen, difficulty breathing, shortness of breath, pain in abdomen or pressure in chest, severe dizziness, weakness, confusion, not urinating, unable to keep your blood glucose above 4 or your blood glucose is above 20 call your health care provider.

In preparation for the flu season, discuss with your family doctor or pharmacist or diabetes team about how to manage your diabetes when you are sick and which medications should be held.

How do we prevent flu?

The most effective way to protect yourself against the flu virus is to get vaccinated.  The benefit of the flu shot is that it prevents flu illness and help protect those who are vulnerable to serious illness.  Flu vaccination has been shown to reduce the risk of death and hospitalization from influenza and pneumonia. It also reduced the rate of hospitalization form respiratory disease, myocardia infract, congestive heart failure and stoke or diabetes events by 70%. Diabetes Canada recommend that those who are living with diabetes get the flu shot yearly.

In addition, to limit the spread of flu virus, stay away from those who are sick and if you are sick, limit your contact with others so you do not transmit the infection to others. When you cough or sneeze, cover your mouth and nose with tissue and put the tissue in a trash bin. Wash your hand frequently with soap and water, if soap and water is not readily available, use alcohol-based hand rub.  Avoid touching your eyes, nose and mouth as this is how the flu virus spread.

What about COVID-19?

As we enter the flu season with the second wave of COVID-19 pandemic, I guess you will have many questions such as:

Is the COVID-19 the same as the flu?  

No. COVID-19 and Flu are not the same. Although they are both caused by viruses, they are caused by different viruses. Flu is caused by influenza virus (A & B) while the COVID-19 is a new virus called Coronavirus.  But flu and COVID-19 are contagious, they spread by droplets released by infected person which can be breathed in or when one touches a soiled surface and transfer the infection to their nose, mouth and eyes by touching their face with contaminated hands.

Can one get flu and COVID-19?

Yes. According to CDC, one can get both flu and covid-19. It is advisable to take the flu vaccination to reduce the burden of the disease when one has both flu and covid-19

How do I differentiate COVID and Flu?

It is difficult to differentiate between COVID-19 and flu by symptoms alone because, both viruses has similar symptoms. There is a Lab test that can differentiate COVID-19 from flu virus.

How do I prevent flu and COVID-19? The flu and COVID 19 can be prevented by hand washing, wearing mask, staying home when sick so you don’t spread the disease to other and maintaining social distance in addition in case of COVID-19, get flu vaccination to prevent flu.

The flu shot does not protect against the COVID-19. As of now, there is no vaccination for COVID-19. Until we get a vaccine, let’s keep wearing the mask, maintain good hand hygiene and social distancing.


CDC: Seasonal influenza (flu)

Government of Canada. Cold or flu: know the difference – Fact sheet –

Husein N, Chetty, A (2018) Influenza, pneumococcal, hepatitis B and Herpes zoster vaccination. Canadian Journal of Diabetes 42: S142- S144.

WHO: How can I avoid getting the flu:

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