How to Treat Cold + Flu with Type 2 Diabetes

Flu season has started, so you’re probably already seeing commercials on TV and hearing HCPs (HCPs) advise you to get your flu shot. But what exactly is influenza (the flu), and how is it different from the common cold? 

This guide covers the key differences and how to manage symptoms if you’re feeling unwell and living with type 2 diabetes (T2D).

The basics: a common cold vs. the flu

The flu is a contagious respiratory disease caused by influenza viruses that infect the nose and throat and can spread to the lungs. A person with influenza can spread it to others within the first three to four days of infection. They may even be contagious one day before symptoms appear and for five to seven days after symptoms start. 

One simple and accessible way to prevent the flu is to get your annual flu shot. It’s important to get this vaccine every year because the shot is updated to match the new versions of the virus.

Unfortunately, there is no vaccine for the common cold. Unlike the flu, the common cold, which different types of viruses can cause, is usually mild. Symptoms usually go away in just a few days.

Key differences between the common cold and flu

When you have diabetes, your immune system is weaker. This means you are more likely to get sick or stay sick than people without diabetes. Symptoms of the illness can persist or worsen. 

This is one important reason you should be aware of the differences. Another important reason to understand the differences in symptoms is that how you manage them alongside your diabetes varies.

You don’t need ChatGPT or WebMD for symptom information—next, we’ll break down answers to common questions about the differences between the cold and the flu for life with diabetes:

• How quickly do symptoms appear? With a common cold, symptoms appear gradually. With the flu, they come on suddenly.
• Will I get a fever? A common cold rarely accompanies a fever, but it is common with the flu.
  
• Will I experience any pain? Sometimes, a cold causes mild pain. With the flu, it’s common to experience pain in any of the areas it affects (head, throat, muscle or body aches). The flu may be more painful than a cold.
• Will I get chills? It’s uncommon with a cold but common with the flu.
• Will I become weak or fatigued? Sometimes a cold causes fatigue and weakness.  The flu may make you feel weak or more tired than usual.
• Will I get congested? With a cold, nasal congestion is common, but with the flu, it sometimes appears.
• Will I develop a sore throat? With a cold, a sore throat is common, but it only happens sometimes with the flu. 
• Will I develop chest discomfort? Chest discomfort is common with the flu, but may be only mild or moderate with a common cold.
• Will I develop a cough? With the flu, a cough is common and sometimes severe (intense) and with a cold, a hacking cough.
• Will I get a headache? It’s rare with a cold but common with the flu.
• How long will my symptoms last? Symptoms that accompany the flu  can last from a few days to close to two weeks. They may also be more severe than a cold. Cold symptoms usually resolve within a few days for most people.

Why the differences in these illnesses matter for people with diabetes

Even the best self-managed people with diabetes (PWD) are more likely to have some complications with the flu, like pneumonia, bronchitis, sinusitis and ear infections. According to Robert Gabbay, M.D., chief scientific and medical officer for the American Diabetes Association (ADA), nearly a third of people hospitalized in recent years with the flu had diabetes.

In addition to common flu symptoms, the infection can interfere with the body’s ability to regulate blood sugar and cause your blood sugar levels to rise or spike. Sometimes, the flu can even cause a loss of appetite, which may lead to a drop in blood sugar levels.

Tips for treating the flu with diabetes

If you have the flu, it’s important to be extremely careful with your diabetes management. 

Here are some tips to manage your symptoms mindfully and return to health:

• Keep taking your diabetes medications, like usual. Don’t miss your doses. If you need support staying on top of them while you’re sick, ask for help from your loved ones.
• Check your blood sugar with your blood glucose meter (BGM) at least every four hours. Write down the results. This can help you and your HCP establish a baseline to decide whether you need to adjust your diabetes medications or management strategy while dealing with the flu.
• If you haven’t already, consider getting a continuous glucose monitor (CGM). CGMs can make it easier to track your diabetes data and reduce the mental burden of managing diabetes while you’re sick. For example, the Freestyle Libre Assist features of the Freestyle Libre 3+ can help you decide how much insulin to take, especially if your meals and snacks are unpredictable when you’re sick. Dexcom G7 offers similar features in its app. These are two popular CGMs for people with diabetes.
• Drink plenty of fluids, like water throughout the day to prevent dehydration. If you are having a hard time keeping down fluids, this may look like you are sipping on water every 15 minutes. You can also drink unsweetened, decaffeinated beverages like tea, but that shouldn’t completely replace water. Limit drinks with caffeine, because they   can be dehydrating and cause your blood sugar levels to vary. If you can’t skip the caffeine, we understand. Balancing your fluid intake is key. If you have a fluid restriction, work with your healthcare team on the best way to stay hydrated. 
• Try to eat normally. We know it can be hard when you’re sick, but your body still needs nutrients. (Even more so now.) Your eating pattern or plan may also have to shift. Do what you can!
• Check your temperature while you have symptoms. A fever may indicate an infection. If you have symptoms of an infection, reach out to your HCP right away to determine if you need medical attention.
• Don’t just write down your blood sugar levels. Keep a written record of your medications, temperature and weight, too. You might even need to check for ketones in your urine if your blood sugar rises.
• Ask your HCP if it makes sense to take Tamiflu as soon as symptoms appear—the generic name of this medication is oseltamivir. Tamiflu may not be right for everyone, but it may help some PWD get through the flu faster. Tamiflu is a commonly prescribed antiviral medication that helps reduce flu symptoms more quickly. It does not cure the flu. 

Other antiviral medication options you can explore with your HCP include: zanamivir (Relenza®), peramivir (Rapivab®) and baloxavir marboxil (Xofluza®). These four options are all FDA-approved. Ask your HCP which one is right for you and how to take it. 

Flu risks for people with type 2 diabetes

If you don’t treat the flu, you could develop serious complications and feel worse. When flu symptoms aren’t managed well or are left untreated, it can even lead to premature death. Don’t underestimate the importance of staying on top of it! If you have diabetes, you should talk to your HCP right away about starting antiviral medications.

Keep your HCP’s phone number handy and call them (or go to the hospital) if you develop:

• Moderate to high levels of ketones in your urine. Though ketones are rare in people with T2D, your HCP may have you check your urine if you’re sick. 
• You feel nauseous and cannot eat.
• You can’t hold fluids for more than four hours (you can’t stop vomiting).
• You’ve had severe vomiting or diarrhea for more than six hours, or you haven’t been able to hold food for more than 24 hours because of the vomiting.
• You lost more than five pounds while ill.
• Your blood sugar levels are less than 3.3 mmol/L (60 mg/dL) or remain above 13.9 mmol/L (250 mg/dL) for an extended period.
• Your temperature is higher than 100° (38°C) for more than 24 hours.
• You have difficulty breathing.
• You feel sleepy, or you can’t think straight. If you can’t think clearly or you feel very sleepy, ask someone else to call your HCP or 911 right away.

Be prepared to adjust your diabetes routine while you’re sick

When you’re not feeling well, you might need to change some parts of your daily routine. For example, you could reduce how much you move around or eat fewer foods high in carbs that can raise your blood sugar. 

You might also need to adjust your medication to stay within your target blood sugar range. Keeping track of your blood sugar and symptoms while you’re sick can help you and your HCP make any necessary changes more easily and quickly.

Your HCP might also suggest taking over-the-counter (OTC) medications to help relieve cold and flu symptoms, such as acetaminophen (Tylenol), Advil or naproxen (Aleve). Always check with your HCP before starting any of these—there are many OTC options, and your HCP can best advise you on which is right for your situation. 

A lot of these medications contain sugar, which you should always keep in mind when living with diabetes.

The cold and flu are scary with diabetes, but you can manage them

Dealing with the common cold or flu sucks, regardless of diabetes, but when you’re living with it, it’s important to nurse your symptoms carefully. Don’t mess around when it comes to the common cold or flu while you’re living with T2D! 

Take care of yourself, get support and check in with your HCP. Make sure to have a sick day plan in place. It may feel tedious, but it’s worth it for peace of mind. Your diabetes needs your attention even more than usual when you’re sick.

To be proactive and possibly even avoid the cold or flu, consider:

• Wearing an N95 mask on planes when you fly.
• Don’t touch your face with unclean or unwashed hands.
• Always wash your hands after you’ve been to different places—yes, even locally, like after you’ve been at the grocery store.
• Use hand sanitizer and carry it with you in your pocket or purse so you don’t forget to use it when handwashing isn’t immediately available.
• Take a multivitamin and eat nourishing foods that support whole body health. It’s a good idea to check with your HCP before starting any new vitamins and supplements.
• Avoid people who are already sick—you can see them another time when they’re feeling well and are no longer at risk of getting you sick.
• Getting your regular vaccines—again, there is no vaccine for the common cold, but there is one for the flu and COVID-19, which is a whole other monster!

Take care and stay healthy this cold and flu season. 

Need support navigating the ins and outs of life with T2D? Download A Beginner’s Guide to Thriving with Type 2 Diabetes.

This educational resource is made possible through the support of Abbott Diabetes Care. Beyond Type 1 retains complete, independent editorial control over all content.