People with diabetes are more at risk of complications arising as a result of infections such as influenza and pneumonia. Elevated blood glucose levels, as a response to infection, can lead to uncontrolled diabetes and the potential danger of diabetic ketoacidosis (DKA) or Hyperglycaemic Hyperosmolar State (HHS), both of which can be fatal if left untreated.

Influenza, or 'flu', is a highly contagious acute viral infection that affects people of all ages. It starts suddenly with:

• fever
• chills
• headache
• aching muscles
• cough or other respiratory symptoms.

How to protect yourself

While most people recover without complications in one to two weeks, flu can cause serious illness and death, especially in the very young, the elderly or those at high risk because of a medical condition. Antibiotics are not effective as a treatment because antibiotics do not work on viruses.

The flu virus changes or mutates, which is why every year a vaccine is produced based on the strains of the virus expected to be circulating. All people with diabetes, including those who are pregnant, should be vaccinated against influenza regardless of age or type of diabetes management. (1)

Vaccine

Vaccination should start after the age of six months and be repeated each year. None of the flu vaccines is licensed for use in children before the age of six months.

The best way to protect children younger than six months who are in a clinical risk group such as diabetes, is to request members of their household and their caregivers be vaccinated. They may not qualify for a free flu vaccination on the NHS but the vaccination is available over the counter at most local pharmacies. (2)

Up to the age of three the dose is half that of an older child or adult, and for children under the age of 13, if they have not previously been vaccinated, the dose should be repeated after four–six weeks for the first year.

Vaccination should be postponed in patients with a feverish illness or infection and avoided in people with a known allergy to eggs, because the vaccine is grown using the protein from hens' eggs.

The flu vaccine is not 'live' and therefore cannot give a person the flu, but because immunity can take up to two weeks to become effective, some people may develop the illness after being vaccinated if they are already incubating the virus in their system.

Possible side effects

After any vaccination you may find that you experience side effects. These happen as the body makes antibodies to the disease and are perfectly natural. They will usually have gone after a couple of days.

The area around the injection site may become red and swollen. A cold flannel will soothe this.

Your temperature may go up and you may feel as if you have caught the flu, but you haven’t. Take paracetamol and plenty of sugar-free drinks.

Your glucose control may be affected and you may find you are running higher than normal. This will settle as your body returns to normal.

If you experience anything other than these after effects – you must let your doctor know.

References

1. The influenza immunisation programme 2009/2010; Department of Health.

2. Influenza information; Department of Health 2010.

Reviewed November 2011.