Having the flu can be dangerous for anyone. But it is extra risky for people with diabetes or other chronic health problems. Having diabetes means having more instances of high blood glucose (blood sugar) than a person without diabetes. High blood glucose hinders your white blood cells’ ability to fight infections.

Beyond people living with diabetes, flu is also extra risky for people with heart disease, smokers and those with chronic lung disease, people who have an impaired immune system (like those going through chemotherapy, or who are organ donation recipients), very young children, and people living in very close quarters, such as college dorms, military barracks, or nursing homes.

Should you get a flu shot?

In general, every person with diabetes needs a flu shot each year. Talk with your doctor about having a flu shot. Flu shots do not give 100% protection, but they do make it less likely for you to catch the flu for about six months.

For extra safety, it's a good idea for the people you live with or spend a lot of time with to get a flu shot, too. You are less likely to get the flu if the people around you don't have it.

The best time to get your flu shot is beginning in September. The shot takes about two weeks to take effect.

If you’re sick (such as having a cold or fever), ask if you should wait until you are healthy again before having your flu shot. And don't get a flu shot if you are allergic to eggs.

You are advised to continue to take the general precautions of preventing seasonal flu and other communicable illnesses and diseases:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash. If you don’t have a tissue, cough or sneeze into your elbow, not your hand.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose, or mouth. Germs spread that way.
• Try to avoid close contact with sick people.
• If you get sick, stay home from work or school and limit contact with others to keep from infecting them.

Many illnesses and diseases spread through contact with body fluids. This contact is commonly through being coughed on. Other close contact with an infected person, such as hugging or kissing them, can lead to the spread as well.

What to do if you have diabetes and symptoms of flu

Talk with your doctor now about how to reach him or her if you think you have the flu. Symptoms of influenza can include:

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills
• Fatigue
• Some people may also have vomiting and diarrhea

People may be infected with the flu and have respiratory symptoms without a fever.

Pneumococcal diseases & pneumonia shots

There is a category of diseases called pneumococcal disease, of which pneumonia is one of the most dangerous—the other most dangerous being meningitis. People with diabetes are about three times more likely to die with flu and pneumococcal diseases, yet most don’t get a simple, safe pneumonia shot.

Symptoms of pneumonia include:

•    Cough that can produce mucus that is gray, yellow, or streaked with blood
•    Chest pain
•    Rapid or difficult breathing
•    Fever
•    Chills

Symptoms of meningitis include:

•    Fever and chills
•    A stiff, immovable neck that gets progressively worse
•    Severe headache
•    Confusion
•    Photophobia (eye sensitivity to light)
•    Lethargy to the point of being unresponsive

About 10,000 people die each year because of these bacterial infections. A pneumonia shot, however, is a safe and effective way to protect you against getting these illnesses. 

The most important step you can take in preventing pneumococcal infection is to get vaccinated. There are two vaccines available in the U.S.:

PCV13 (Prevnar 13®) vaccine: Short for pneumococcal conjugate vaccine, the PCV13 vaccine protects against 13 types of pneumococcal bacteria. It is given as a single dose vaccine for adults, and in four small doses to babies: at 2 months, 4 months, 6 months, and 12–15 months of age. The CDC recommends this vaccine for: 

• Children under the age of 2
• Adults 65 and older
• People 2 to 64 years of age who also: 
  • Have a chronic disease, such as diabetes; heart, liver, kidney, or lung disease; or alcoholism 
  • Have health issues that weaken their immune system, such as HIV/AIDS, cancer, or a damaged or absent spleen 
  • Have cochlear implants or cerebrospinal fluid leaks 
  • Smoke 

PPSV23 (Pneumovax23®) vaccine: Short for pneumococcal polysaccharide vaccine, the PPSV23 vaccine protects against 23 types of pneumococcal bacteria. It is a single-dose shot. The CDC recommends this vaccine for:

• Adults 65 years and older
• Adults 19 to 64 years of age who smoke cigarettes
• People 2 to 64 years of age who also:
  • Have chronic diseases, such as diabetes; heart, liver, kidney, or lung disease; or alcoholism
  • Have health issues that weaken their immune system, such as HIV/AIDS, cancer, or a damaged or absent spleen
  • Have cochlear implants or cerebrospinal fluid leaks 

Talk to your doctor about a plan to get both of these vaccines. Typically, you’ll get one vaccine, wait a year, and then get the second immunization.

Other recommended vaccines

• Tdap vaccine (tetanus, diphtheria, and pertussis)
• Hepatitis B vaccine (in three parts)
• Zoster vaccine (shingles)

Paying for vaccines

Both the pneumonia and meningitis vaccines are covered by Medicare Part B if the vaccines are given one year apart. Learn more at medicare.gov/coverage/pneumococcal-shots. 

Most private insurance programs cover pneumococcal vaccines at low or no cost. The Vaccines for Children program covers the vaccine for those 19 and younger if they’re Medicaid-eligible, uninsured or underinsured, or American Indian or Alaska Native. Learn more at cdc.gov/vaccines/programs/vfc/.

Other resources

• ADA Center for Information: Call 1-800-DIABETES (800-342-2383), 9:00 a.m. to 5:30 p.m. ET, Monday–Friday, or email askada@diabetes.org.
   
• Pandemicflu.gov: One-stop access to U.S. Government swine, avian and pandemic flu information
   
• Flu Clinic Locator: The American Lung Association collaborated primarily with the Centers for Disease Control and Prevention (CDC), the Influenza Summit, and the Immunization Action Coalition to compile a comprehensive database of clinics offering flu shots. All you need to do to find a clinic near you is enter your zip code.