You may have heard that people with medical conditions like diabetes have a higher risk of complications from H1N1 flu (aka "swine flu"). That's not as scary as it sounds, though. At the moment, H1N1 flu is no more serious than regular seasonal flu — and any kind of flu can affect diabetes control.

As anyone with diabetes knows, even when you do your best job of monitoring and making medication adjustments, blood sugar levels can be harder to manage when you're sick. 

But how do you know when a problem is a real emergency? When should you call your doctor? And when should you head to the emergency room?

Here are some tips.

When to Call Your Doctor

If you have flu, get in touch with your doctor or someone on your diabetes management team if:

• you have no appetite or you can't eat or drink
• you've had a low blood sugar reaction or your blood sugar levels are running low (in addition to calling your doctor's office, do what you can at home to bring your blood sugar back up)
• your flu symptoms include throwing up or having diarrhea
• your blood sugar levels remain high over several checks or they don't decrease when you take extra insulin

Your doctor's office will probably want to know your blood sugar and urine ketone levels (and blood ketone levels if your doctor has told you to test them). So have the results of your recent tests — and the time you did the checks — handy when you call.

If you have flu (or think you do) and can take your temperature, write those results down too.

When It's an Emergency

Get emergency medical care if:

• you have moderate or large amounts of ketones in your urine (or in your blood if you test blood ketone levels) along with nausea, vomiting, abdominal pain, or breathing difficulty
• your blood sugars are low and aren't coming up with treatment
• you have a severe hypoglycemic reaction (in which case you should be given glucagon at home before contacting a doctor or getting emergency help)
• you feel dizzy, lightheaded, faint, or confused

Be Prepared

Get ready for flu season. Eat healthy foods and get plenty of exercise and sleep. Follow your diabetes management plan, even when you're feeling OK. If you notice your diabetes doesn't seem as well controlled as it used to be, now is a good time to talk to your doctor and go over your plan.

Your parents, teachers, coaches, and good friends should all know how to help you in case of a low blood sugar emergency — or they should know to call 911 if they see you having potentially serious diabetes symptoms.

Most people with diabetes who get the flu won't run into any serious problems. So try to relax. At the moment, the new strain of H1N1 doesn't look like it would cause people with diabetes to get any sicker than the regular seasonal flu would.

Reviewed by: Steven Dowshen, MD
Date reviewed: October 2009

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