Tips to help you avoid or treat colds & flu
Colds and flu season is upon us. They can make diabetes management more difficult than usual. There is a lot of talk about a more virulent flu strain, the Australian flu, which makes us fear any kind of bug at the moment. While it is impossible to guarantee remaining flu free, there are things we can do to keep ourselves healthy and less likely to get colds and flu. Here are my tips for managing diabetes to stay well and when you are ill.
Prevention is the best policy:
- Pay particular attention to BG. Test often and deal with high BG with insulin and/or cut back on high carb and sugary foods. Germs love sugar so if your BG levels are high it will be a very inviting atmosphere for them.
- Eat more vegetables particularly garlic, onion, green leafy vegetables, peppers, chili, herbs and spices. Eat some whole fruit (not just the juice) but not too much as it contains glucose.
- Drink plenty of water. Staying well hydrated helps to stabalise BG and helps the body to flush out bugs.
- Get exercise (outside if possible). Exercise helps stabilise BG levels and improves the immune system, making it more difficult for germs to take hold.
5. Wash your hands often, particularly after being in crowded areas and after handling door handles, keyboards etc. Clean keboard, phone covers etc with antibacterial wipes.
6. Get plenty of rest.
If you get flu:
- Drink lots of water, preferably warm. It helps to get rid of flu bugs and is also good for BG level.
- Get plenty of rest. It is often better to take a few days to rest at the start of a cold, rather than wait until you get very sick and have to take a couple of weeks to recover and run the risk of complications.
- Some cold and flu remedies aren’t recommended for diabetics, e.g. Sudafed, Sinutab and other decongestants. Paracetamol is fine unless you have been told otherwise.
- Remedies with added sugar should also be avoided if possible. Check what is in your chosen remedy. Ask your pharmacist for guidance. See my list of names given to added sugar http://theartisandiabetic.ie/sugar-artificial-sweeteners/
- Cold & flu remedies have poor carbohydrate labelling. Cold remedies like Beechams and Lemsip contain various amounts of carbs depending on the flavour and strength. They vary from 2g to 10g of carb. Not a huge amount, but I count carbs of over 5g and factor them in for insulin dosage. Throat lozenges contain carbs unless the sugar-free ones are used. Paracetamol is usually fine, but consult your pharmacist if you are on other medications.
- Remedies which aren’t consumed. e.g., sinus rinses, Vicks Vaporub and essential oils are ideal because they don’t affect BG levels.
- I find honey very effective for a sore throat or a cough. It contains approx 6g of carbohydrate per level teaspoon. Don’t forget to give insulin to cover the carbs. Other good ingredients for colds are ginger, garlic, thyme and other herbs. They don’t contain enough carbs to count.
- Check your BG level every 2 hours when you are ill. It is very important to also check either blood or urine for ketones (every 2 hours). Keytones are fatty acids which are produced when the body is no longer able to cope with excess glucose in the blood. Cells are unable to get the glucose they need to keep the body functioning. It can lead to a potentially life-threatening condition called diabetic ketoacidosis (DKA). This can occur in delayed type 1 diagnosis, when diabetes is not controlled or due to illness. If you are unsure check that your BG meter checks ketones and that you understand how to read the results.
- If you have ketones carry out the instructions given to you by your medical practitioner immediately. This will include giving additional insulin and drinking lots of water. You will also have been told not to consume very sugary foods. If ketones are still present 2/4 hours later further action is necessary. If you have them for several hours and can’t manage to get them reduced you should contact your diabetes team or if you are very unwell attend A & E.
- When you are ill the body can become resistant to insulin and more will be required to keep BG in your target range and prevent DKA. As you can see from the points above its easy to have added sugar without realising it (in cold remedies, hot drinks etc). This coupled with insulin resistance and reduced exercise can quickly cause serious BG issues.
- It’s important to eat light but nourishing foods like soups, give enough insulin to cover these meals and to add any corrective insulin needed. If you are eating extra fruit you will need extra insulin for it. Peppers, spinach, all green veg, kiwi and citrus fruit all contain vitamin C. Zinc is important as well and pumpkin seeds, walnuts and shellfish are good sources. Vitamin D is important for fighting infection and is found in oily fish, eggs and full-fat dairy products. Dairy products encourage mucus build up, so are best avoided during a cold or flu.
- If your BG is very high and difficult to get down I recommend writing down everything you eat and drink and your insulin dosages so that you will be able to judge what worked or didn’t work in the previous hours/days. If you are ill and have a temperature it is unlikely you will remember. Allowing BG to remain high will result in delayed recovery, add to the unwell feeling and can contribute to diabetes complications in the long run.
- It’s important that you tell a friend or family member that you are ill and may need assistance (they may make some nice soup for you!).
- Recovery often takes longer for people who have diabetes. If you feel a lot worse, have other health conditions or think you may have an infection it’s important to contact your Doctor. Elderly people with diabetes and parents of young children with T1 need to be particularly vigilant about the severity of symptoms and contact their Doctor immediately if they are worried.
Recovery and Insulin:
- If you had to greatly increase your insulin dose while you were sick, you will need to be careful of your BG levels when you start to get better. Your insulin requirement should return to normal. This can happen overnight or it may be a gradual process of needing a little less insulin every day. This can lead to hypos (low BG episodes) so it’s very important to test often and adjust your insulin dose as necessary. http://theartisandiabetic.ie/hypoglycemia-hypo/
If we do get colds or flu hopefully they will be shortlived.