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Donna Lazorik Posted by Donna Lazorik, RN, MS. Donna is the Immunization Coordinator in the Division of Epidemiology and Immunization at the Massachusetts Department of Public Health.

Whether it’s type 1 or type 2, well-managed or uncontrolled – diabetes and the flu don’t mix well.

When people with diabetes get the flu they have a higher risk of complications like hospitalization and even death.  Why is this?  Diabetes can make the immune system less able to fight the influenza virus that causes the flu.  In addition, sometimes people don’t feel like eating when they are sick.  It may be difficult to maintain a regular diet or medication regimen, and this can cause blood sugar levels to rise or fall.  Flu infection itself can also raise blood sugars.  Even people whose diabetes is well controlled need to have a plan to manage their condition when they are sick.

Vaccination is the best protection against flu.  The Centers for Disease Control and Prevention (CDC) recommends that people with diabetes who are six months and older get a flu shot every year. (It’s important to note that the nasal spray flu vaccine should not be given to people with diabetes.)  People with diabetes are also at increased risk of developing pneumonia from the flu, therefore a pneumonia (pneumococcal) vaccine is also recommended and should be part of a diabetes management plan. 

We saw the impact of flu on people with diabetes during the 2009 H1N1 flu pandemic – one in four patients with diabetes who were hospitalized for flu required intensive care.  While these data are alarming, it sends the message that people with diabetes need to protect themselves against the flu.

The best time to get vaccinated is before flu season starts (in other words, now) and before people around you start becoming sick or ill.  The flu vaccine is safe and effective.  In fact, it has been shown to reduce the number of hospitalizations and deaths in people with diabetes.

If you have questions about the flu or flu vaccine, visit or contact the Department of Public Health, Division of Epidemiology and Immunization at (617) 983-6800.  To find out where you can get a flu shot, talk with your health care provider or visit to find a flu clinic near you.  

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